Surgical tray efficiency system and related methods

ABSTRACT

A surgical tray efficiency system comprising a vertical rack assembly for holding and displaying a plurality of surgical instrument trays, a sterile barrier covering the vertical rack assembly and including tray location identifiers, and a standardization software platform including a customizable interactive planogram is described. The customizable interactive planogram software helps operating room staff arrange the instrument trays on the vertical rack assembly according to a predetermined customizable location ID, and create/load/access information related to the surgical procedure/trays/instruments before, during, and after the surgery.

CROSS-REFERENCES TO RELATED APPLICATIONS

The present application is a non-provisional application claiming thebenefit of priority from commonly owned and co-pending U.S. ProvisionalApplication Ser. No. 62/317,544 filed on Apr. 2, 2016 and entitled“SURGICAL TRAY EFFICIENCY SYSTEM,” and is a continuation-in-part of U.S.application Ser. No. 15/055,280 filed Feb. 26, 2016 and entitled“CANTILEVER ORGANIZATIONAL RACK SYSTEM FOR SUPPORTING SURGICALINSTRUMENTATION,” which claims the benefit of priority from U.S.Provisional Application Ser. No. 62/121,710 filed on Feb. 27, 2015 andentitled “CANTILEVER ORGANIZATIONAL RACK SYSTEM FOR SUPPORTING SURGICALINSTRUMENTATION,” the entire content of each aforementioned patentapplication is hereby incorporated by reference into this disclosure asif set forth fully herein.

FIELD

The present invention relates generally to the effective organizationand use of surgical instrumentation for a given surgical procedure. Inparticular, the invention relates to system of component devices; ahardware component, a sterile barrier with location identification, anda software platform.

BACKGROUND

Various cabinets, racks, tables and shelving have been used forassembling, storing, and transporting medical instruments, tools, andimplant devices throughout hospitals and surgery centers for medicaloperations and procedures. Typically surgical instruments, tools andimplant devices are washed, sterilized, wrapped, and stored untilrequired instrumentation is set up in the operating room prior tosurgery or a medical procedure.

The numerous personnel including but not limited to patients, hospitaladministration, surgeons, nursing staff, scrub technicians, sterileprocessing employees, device manufacturers, manufacturers'representatives along with the vast number of tools and instrumentsrequired for a specific surgery creates a need for precise coordination.The number of incidents that occur because of miscommunication, lack ofteamwork and the extensive level of variables can be hard to quantifyand are rarely published, however the monetary cost can be estimatedusing an average operating cost per min. Incidents that occur in andaround the operating room have been found to incur high monetary costsand correlate directly with increased infection rates and lengthenedrecovery times. The lack of procedure protocols prior to, during, andafter surgery increases the risk of incidents and contributes to highhealth care costs.

SUMMARY

Operating efficiency and production is being propelled by patientexpectations, health care regulations, and advancing technology. Despiteincreasing efforts to capitalize on the glaring complications in theoperating environment, miniscule achievements have been developed. Thepresent invention increases efficiency in the operating room byestablishing a workflow network within the operating environment byimplementing an effective system that creates accountability andstandardizes patient care. By focusing on systematic proceduraltechniques with equipment and personnel workflow, the number ofhazardous outcomes can be reduced.

The present invention is directed to various designs for a surgical trayefficiency system for use in the operating room during surgery to holdinstruments. Preferred features for the design of the present inventioninclude the following:

-   -   i. multi-level rack design with adjustable angle shelves;    -   ii. modular rack units and options allow for customized room        set-up based on surgeon, procedure, instrument requirements, and        space limitations;    -   iii. mobility for easy movement of the racks around the hospital        and operating room;    -   iv. rack includes a custom sterile drape;    -   v. rack allows for co-branding opportunities, such as company        and hospital brand, procedure techniques, logos, etc.    -   vi. adjustable spine angle and orientation for technician or        surgeon comfort and/or visual preferences;    -   vii. rack may be designed to support at least 2 or more full        instruments trays per shelf level;    -   viii. rack ensures a consistent protocol for the use of surgical        instruments; and    -   ix. rack utilizes a specialized location planogram software        system that creates consistency throughout the surgical industry        it is being used in.

Various embodiments of the present invention may exhibit one or more ofthe following objects, features and/or advantages:

-   -   i. reduces or eliminates need for sterile cloth drapes to cover        stainless steel tables;    -   ii. helps organize equipment trays with increased visibility        from across the room and accessibility of instruments inside an        operating room;    -   iii. reduces occurrence of situations where instruments are lost        or misplaced due to a disorganized and inconsistent surgical        room set-up and inventory management;    -   iv. allows accessible and organized surgery room storage of        hundreds of instruments;    -   v. prevents instrument trays from being “stacked” together        during long surgical procedures and associated risk of bacteria        growth;    -   vi. reduces or eliminates sterile field violations due to lack        of floor space in sterile working area;    -   vii. helps reduce hospital infection rate;    -   viii. improved portability, instrument work space, efficiency,        safety and/or standardization;    -   ix. helps to reduce the number of personnel in the operating        room during surgery;    -   x. reduces inefficiencies associated with instrumentation and        implant use;    -   xi. creates opportunity for better space management of operating        rooms;    -   xii. creates a standardized protocol for instrumentation use        depending on surgery type, surgeon, and device manufacturer; and    -   xiii. allows a manufacturer's representative to be more        effective and efficient.

The vertical rack organizational system of the present invention helpsto increase efficiency in the operating room by: (1) improvingorganization (by having a specified location for each instrument tray);(2) increasing the space available for instrument trays; (3) ensuringevery tray has the necessary instruments before the procedure begins;(4) increasing visibility of the instruments for the surgeon and supportstaff; (5) enhancing the tracking of tools; (6) reducing surgery time;and (7) decreasing the incidence of misplaced instruments before,during, or after procedures.

The vertical rack organization system accomplishes this by using amodular hardware system that adapts with seamless integration using amultifaceted software structure including a planogram set up to map tooland tray location. The modular hardware system comprises a vertical rackthat includes a base, support arms, instrument shelves, and a header.The base may function to support the load, store or house a power supplyand/or systems (mechanical and/or electrical) for adjusting or movingaspects of the modular hardware system, and provide smooth mobility (viaattached lockable castors, for example) to enable out of the waystorage. The instrument shelves are configured to receive sterileinstrument trays, and may be provided in different lengths that would beappropriate for accommodating a single column of trays (e.g.“single-wide”), two columns of trays (“e.g. double-wide”), three columnsof trays (e.g. “triple-wide”), and so forth. The instrument shelves maybe color-coded and numbered. The numbering and color-coding systemcorresponds to specific instrument trays, ensuring their properplacement within the vertical rack system.

As additional description to the embodiments described below, thepresent disclosure describes the following embodiments.

Embodiment 1 is a system for increasing efficiency in an operating roomenvironment during a surgical procedure, comprising: (1) a multi-levelshelf assembly comprising a plurality of elongated shelves verticallyseparated from one another, each elongated shelf configured to hold atleast one standard surgical instrument tray; (2) a sterileidentification barrier overlaying the multi-level shelf assembly tocreate a physical barrier between a sterile field of an operating roomand the multi-level shelf assembly, the sterile identification barrierincluding a plurality of tray-receiving areas, each sized and configuredto overlay at least a portion of one of the elongated shelves, and eachtray-receiving area having a unique tray-receiving area locationidentifier associated therewith; and (3) computer-readable mediaincluding instructions that, when executed by one or more processors,are configured to cause a computer system to: (a) receive surgicalplanning data that is related to a given surgical procedure and that isinput by a user and (b) provide, on a display device, an interactivepresentation of the surgical planning data.

Embodiment 2 is the system of embodiment 1, wherein each elongated shelfhas a generally planar display surface.

Embodiment 3 is the system of embodiments 1 or 2, wherein the pluralityof elongated shelves includes a first shelf having a generally planardisplay surface oriented parallel to the ground.

Embodiment 4 is the system of embodiment 3, wherein the plurality ofelongated shelves includes a second shelf having a generally planardisplay surface arranged in a nonparallel orientation relative to thefirst shelf.

Embodiment 5 is the system of any one of embodiments 1 through 4,wherein each tray-receiving area is configured to contain only onestandard surgical instrument tray therein.

Embodiment 6 is the system of any one of embodiments 1 through 5,wherein the surgical planning data comprises (i) surgical instrumenttray content that indicates surgical instruments to be stored on varioussurgical instrument trays, and (ii) tray-receiving area locationidentifiers that correspond directly to the tray-receiving area locationidentifiers of the sterile identification barrier, and that indicate thelocations of the various surgical instrument trays on the sterileidentification barrier during the given surgical procedure.

Embodiment 7 is the system of embodiment 6, wherein the interactivepresentation includes: (i) the surgical instruments that are to bestored on the various surgical instrument trays, and (ii) the locationsof the various surgical instrument trays on the sterile identificationbarrier during the given surgical procedure.

Embodiment 8 is the system of any one of embodiments 4 through 7,wherein the plurality of elongated shelves further includes a thirdshelf having a generally planar display surface arranged in anonparallel orientation relative to the first shelf.

Embodiment 9 is the system of embodiment 8, wherein the generally planardisplay surface of the third shelf is arranged in a nonparallelorientation relative to the second shelf.

Embodiment 10 is the system of embodiments 8 or 9, wherein the pluralityof elongated shelves further includes a fourth shelf having a generallyplanar display surface arranged in a nonparallel orientation relative tothe first shelf.

Embodiment 11 is the system of embodiment 10, wherein the generallyplanar display surface of the fourth shelf is arranged in a nonparallelorientation relative to the second and third shelves.

Embodiment 12 is the system of embodiment 10 or 11, wherein the first,second, third and fourth shelves are equal in length.

Embodiment 13 is the system of any one of embodiments 10-12, wherein thefirst shelf has a width dimension that is greater than the widthdimensions of the second, third, and fourth shelves.

Embodiment 14 is the system of any one of embodiments 1 through 13,wherein the display device is attached to the multi-level shelfassembly.

Embodiment 15 is the system of any one of embodiments 1 through 14,wherein unique location identifiers on the sterile identificationbarrier comprise at least one of letters, numbers, colors, symbols, andwords.

Embodiment 16 is the system of any one of embodiments 1 through 15,wherein the sterile identification barrier further includes a pluralityof bendable wires positioned thereon to secure the sterileidentification barrier to the multi-level shelf assembly.

Embodiment 17 is the system of any one of embodiments 1 through 16,wherein the sterile identification barrier is at least partially securedto the multi-level shelf assembly by hook and loop fasteners.

Embodiment 18 is the system of any one of embodiments 1 through 17,wherein the surgical instrument tray content comprises a plurality ofsurgical instruments.

Embodiment 19 is the system of any one of embodiments 1 through 18,wherein the surgical planning data input by the user further comprisesone or more of hospital name, surgeon name, procedure name,procedure-related literature, procedure-related video media,instrument-specific video media, instrument images, and surgerypreference notes.

Embodiment 20 is the system of any one of embodiments 1 through 19,wherein the instructions are further configured to cause the computersystem to: (i) provide one or more user interface elements that enable auser to search for a surgical instrument by name, and (ii) present, inresponse to user input that provides a name of a surgical instrument andinitiates a search using the one or more user interface elements,information that indicates a surgical instrument tray on which asurgical instrument having the name is located.

Embodiment 21 is the system of embodiment 20, wherein the interactivepresentation includes a virtual representation of the location on thesterile identification barrier of the surgical instrument that has thename.

Embodiment 22 is the system of any one of embodiments 1 through 21,wherein the multi-level shelf assembly is mounted to the ceiling of theoperating room.

Embodiment 23 is the system of any one of embodiments 1 through 22,wherein the instructions are further configured to cause the computersystem to: (i) receive a request to provide a second computer systemthat coordinates movements of a robotic device with a location of aparticular surgical instrument, wherein the request indicates theparticular surgical instrument; (ii) identify a surgical instrumenttray, of the various surgical instrument trays, at which the particularsurgical instrument is located; and (iii) send, for receipt by thecomputer system that coordinates movements of the robotic device inresponse to having received the request, information that indicates thesurgical instrument tray at which the particular surgical instrument islocated.

Embodiment 24 is the system of embodiment 23, wherein the instructionsare further configured to cause the computer system to: (iv) receive,from the computer system that coordinates movements of the roboticdevice, information that indicates that the robotic device has retrievedthe particular surgical instrument; and (v) provide, on the displaydevice, an update to the interactive presentation to visually indicatethat the particular surgical instrument has been retrieved by therobotic device.

Embodiment 25 is a method for increasing efficiency in an operating roomenvironment during a given surgical procedure, comprising the steps of:(1) providing a plurality of surgical instrument trays, each containingone or more surgical instruments related to the given surgicalprocedure; (2) providing a multi-level shelf assembly comprising aplurality of elongated shelves vertically separated from one another,each elongated shelf having a generally planar display surfaceconfigured to hold at least one surgical instrument tray; (3) draping asterile identification barrier over the multi-level shelf assembly tocreate a physical barrier between the sterile field of the operatingroom environment and the multi-level shelf assembly, the sterileidentification barrier including a plurality of tray-receiving areas,each sized and configured to overlay at least a portion of one of theelongated shelves, each tray-receiving area having a unique locationidentifier associated therewith; (4) inputting surgical planning datarelated to a given surgical procedure into a computer system; and (5)interacting, with a computer system that is providing, on a displaydevice, an interactive presentation of a compilation of the surgicalplanning data, to cause the display device to present a particularaspect of the surgical planning data.

Embodiment 26 is the method of embodiment 25, wherein eachtray-receiving area is configured to contain only one surgicalinstrument tray therein.

Embodiment 27 is the method of embodiments 25 or 26, wherein thesurgical planning data comprises: (i) surgical instrument tray contentthat indicates surgical instruments to be stored on various surgicalinstrument trays, and (ii) tray-receiving area location identifiers thatcorrespond directly to the tray-receiving area location identifiers ofthe sterile identification barrier, and that indicate the locations ofthe various surgical instrument trays on the sterile identificationbarrier during the given surgical procedure.

Embodiment 28 is the method of any one of embodiments 25 through 27,further comprising the step of: affixing a unique location identifiertag to the surgical instrument trays, the unique location identifier tagcorresponding to the locations of the various surgical instrument trayson the sterile identification barrier during the given surgicalprocedure.

Embodiment 29 is the method of any one of embodiments 25 through 28,further comprising the step of: placing the specific surgical instrumenttray with affixed location identifier tag within the tray-receiving areahaving the corresponding tray-receiving area location identifier.

Embodiment 30 is the method of any one of embodiments 25 through 29,wherein the compilation of the surgical planning data includes: (i) thesurgical instruments that are to be stored on the various surgicalinstrument trays, and (ii) the locations of the various surgicalinstrument trays on the sterile identification barrier during the givensurgical procedure.

Embodiment 31 is the method of any one of embodiments 25 through 30,wherein the particular aspect of the surgical planning data includes anenlarged view of the particular surgical instrument tray.

Embodiment 32 is the method of any one of the embodiments 25-31, whereinthe display device is attached to the multi-level shelf assembly.

Embodiment 33 is the method of any one of embodiments 25 through 32,wherein unique location identifiers on the sterile identificationbarrier comprise at least one of letters, numbers, colors, symbols, andwords.

Embodiment 34 is the method of any one of embodiments 25 through 33,wherein the surgical planning data input by the user comprises one ormore of hospital name, surgeon name, procedure name, procedure-relatedliterature, procedure-related video media, instrument-specific videomedia, instrument images, and surgery preference notes.

BRIEF DESCRIPTIONS OF THE DRAWINGS

Many advantages of the present disclosure will be apparent to thoseskilled in the art with a reading of this specification in conjunctionwith the attached drawings, wherein like reference numerals are appliedto like elements and wherein:

FIG. 1 is a perspective view of an example of a surgical tray efficiencysystem according to the disclosure;

FIG. 2 is a perspective view of one example of vertical rack assemblyforming part of the surgical tray efficiency system of FIG. 1;

FIG. 3 is a front plan view of the vertical rack assembly of FIG. 2;

FIG. 4 is a top plan view of the vertical rack assembly of FIG. 2;

FIGS. 5-6 are side plan views of the vertical rack assembly of FIG. 2;

FIG. 7 is a rear perspective view of the vertical rack assembly of FIG.2;

FIG. 8 is a front plan view of another example of a vertical rackassembly forming part of the surgical tray efficiency system of FIG. 1;

FIG. 9 is a perspective view of the vertical rack assembly of FIG. 8;

FIG. 10 is a perspective view of an example of a base frame forming partof the vertical rack assembly of FIG. 8;

FIG. 11 is a top plan view of the base frame of FIG. 10;

FIG. 12 is a perspective view of an example of a pair of verticalsupports forming part of the vertical rack assembly of FIG. 8

FIG. 13 is a top plan view of the pair of vertical supports of FIG. 12;

FIG. 14 is a perspective view of an example of a protective shellforming part of the vertical rack assembly of FIG. 8;

FIG. 15 is a side plan view of the protective shell of FIG. 13;

FIG. 16 is a perspective view of an example of a first shelf formingpart of the vertical rack assembly of FIG. 8;

FIG. 17 is a perspective view of an example of a second shelf formingpart of the vertical rack assembly of FIG. 8;

FIG. 18 is a perspective view of an example of a third shelf formingpart of the vertical rack assembly of FIG. 8;

FIG. 19 is a perspective view of an example of a fourth shelf formingpart of the vertical rack assembly of FIG. 8;

FIG. 20 is a side plan view of the fourth shelf of FIG. 19;

FIGS. 21-22 are perspective and side plan views, respectively, of anexample of a first side support panel forming part of the vertical rackassembly of FIG. 8;

FIGS. 23-24 are perspective and side plan views, respectively, of anexample of a second side support panel forming part of the vertical rackassembly of FIG. 8;

FIG. 25 is a perspective view of an example of a first rear panelforming part of the vertical rack assembly of FIG. 8;

FIG. 26 is a perspective view of an example of a second rear panelforming part of the vertical rack assembly of FIG. 8;

FIG. 27 is a perspective view of an example of a third rear panelforming part of the vertical rack assembly of FIG. 8;

FIG. 28 is a front plan view of another example of a vertical rackassembly forming part of the surgical tray efficiency system of FIG. 1;

FIG. 29 is a rear perspective view of the vertical rack assembly of FIG.2 with an example of an attached x-ray shield;

FIG. 30 is a side plan view of the vertical rack assembly of FIG. 29;

FIG. 31 is a rear plan view of the vertical rack assembly of FIG. 29;

FIG. 32 is a front plan view of an example of a sterile identificationbarrier forming part of the surgical tray efficiency system of FIG. 1;

FIG. 33 is a rear plan view of the sterile identification barrier ofFIG. 32;

FIG. 34 is a front plan view of another example of a sterileidentification barrier forming part of the surgical tray efficiencysystem of FIG. 1;

FIG. 35 is a rear plan view of the sterile identification barrier ofFIG. 34;

FIG. 36 is a perspective view of the vertical rack assembly of FIG. 2combined with the sterile identification barrier of FIG. 34 and anassociated plurality of surgical instrument trays;

FIGS. 37-44 are perspective views of the sterile identification barrierof FIG. 34, illustrating a sequence of folding the sterileidentification barrier;

FIGS. 45-50 illustrate an example of a sequence of folding the foldedsterile identification barrier of FIG. 44 within an outer wrap;

FIG. 51 is a perspective view of a folded sterilization barrier andouter wrap combination sealed within packaging;

FIG. 52 is a perspective view of a monitor cover suitable for use withthe surgical tray efficiency system of FIG. 1;

FIG. 53 is a plan view of a rack cover suitable for use with thesurgical tray efficiency system of FIG. 1;

FIG. 54 is a flowchart depicting the framework and logic flow of thestandardization software platform forming part of the surgical trayefficiency system of FIG. 1;

FIGS. 55-76 are plan views of various graphic user interface (GUI)screens forming part of the standardization software platform of FIG.54;

FIG. 77 is a perspective view of one example of a vertical rack assemblyof FIG. 2 adapted to hang from a ceiling;

FIG. 78 is a perspective view of another example of a vertical rackassembly forming part of the surgical tray efficiency system of FIG. 1;

FIG. 79 is a perspective view of an example of an item identificationunit for use with the surgical tray efficiency system of FIG. 1;

FIG. 80 is a perspective view of another example of a vertical rackassembly forming part of the surgical tray efficiency system of FIG. 1,highlighting the use of additional lighting;

FIG. 81 is is a perspective view of another example of a vertical rackassembly forming part of the surgical tray efficiency system of FIG. 1,highlighting the attachment of an additional utility tray; and

FIG. 82 is a block diagram of computer systems forming part of thesurgical tray efficiency system of FIG. 1.

DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT

Illustrative embodiments of the invention are described below. In theinterest of clarity, not all features of an actual implementation aredescribed in this specification. It will of course be appreciated thatin the development of any such actual embodiment, numerousimplementation-specific decisions must be made to achieve thedevelopers' specific goals, such as compliance with system-related andbusiness-related constraints, which will vary from one implementation toanother. Moreover, it will be appreciated that such a development effortmight be complex and time-consuming, but would nevertheless be a routineundertaking for those of ordinary skill in the art having the benefit ofthis disclosure. The surgical tray efficiency system and related methodsdisclosed herein boasts a variety of inventive features and componentsthat warrant patent protection, both individually and in combination.

FIG. 1 illustrates one example of a surgical tray efficiency system 10designed for use in an operating room during surgery. By way of example,the surgical tray efficiency system 10 includes a vertical rack assembly12, a sterile identification barrier 14, and a standardization softwareplatform 16, shown by way of example on a portable tablet computer 17.The various components of the surgical tray efficiency system 10interact with one another to enable operating room personnel to quicklylocate and retrieve requested instrumentation during surgery, therebyimproving operating room efficiency and reducing surgery time. Morespecifically, the vertical rack assembly 12 is ergonomically designed toutilize vertical space in the operating room by having a plurality ofangled shelves that each support one or more surgical instrument trays.The vertical rack assembly 12 has a relatively small footprint tosurface area ratio, which maximizes the number and accessibility ofsurgical instrument trays while occupying a minimal amount of valuablefloor space within the operating room. The sterile identificationbarrier 14 allows the vertical rack assembly 12 to be positioned insidethe sterile field in an operating room by establishing a sterile barrierbetween the vertical rack assembly 12 and the rest of the operatingroom. Additionally, the sterile identification barrier 14 may includelabels that correlate to a specific location or region on the sterileidentification barrier 14 which, in conjunction with the standardizationsoftware platform 16, allows the operating room personnel to maintainconsistency of the placement of the various instrument trays accordingto the preferences and/or pre-planning by the surgical team. Thestandardization software platform 16 guides a user where to place aninstrument tray for a given labeled location on the sterileidentification barrier 14. Thus, the surgical tray efficiency system 10increases operating room efficiency by (a) having a consistent,specified location for each instrument tray; (b) increasing the spaceavailable for instrument trays; (c) ensuring every tray has thenecessary instruments before the procedure begins; (d) increasingvisibility of the instruments for the surgeon and support staff; (e)enhancing the tracking of surgical instruments; and (f) decreasing theincidence of misplaced instruments before, during, or after surgicalprocedures.

FIGS. 2-7 illustrate one example of a vertical rack assembly 12according to the present disclosure. By way of example, the verticalrack assembly 12 includes a base assembly 18, shelf assembly 20, and amonitor assembly 22. The base assembly includes a support structure 24,a shell 26, and a plurality of mobility elements 28. The shelf assembly20 includes a plurality of metal shelves, each configured to hold atleast one surgical instrument tray. The vertical rack assembly 12 shownby way of example in FIGS. 2-6 includes a first shelf 30, a second shelf32, a third shelf 34, and a fourth shelf 36, each of which areconfigured to hold and display at least two standard sized (e.g. 23×11inches) surgical instrument trays (e.g. “double-wide”). Other shelfconfigurations are possible, such that the vertical rack assembly 12 maybe provided with more shelves or fewer shelves, and/or shorter shelves(e.g. “single-wide” shelves configured to hold at least one standardsized instrument tray per shelf) or longer shelves (e.g. “triple-wide”shelves configured to hold at least three standard sized instrumenttrays per shelf) depending on the instrumentation needs of a particularsurgical procedure. The shelf assembly 20 further includes first andsecond lateral support panels 38, 40, first, second, and third rearpanels 42, 44, 46, a grab handle 48, and a pivot bar 50. The monitorassembly 22 includes a monitor 52, monitor support 54, and a pivothandle 56. Optionally, the vertical rack assembly 12 may include anattached mounting element for at least temporarily receiving theportable electronic device 17 that is used to interface with thestandardization software platform 16. The vertical rack assembly 12 mayalso include an attached container for housing a plurality of sterileidentification barriers 14 therein.

The various views presented in FIGS. 3-5 not only show differentperspectives of the component parts that make up the vertical rackassembly 12, they also highlight certain advantageous characteristics ofthe vertical rack assembly 12. For example, FIG. 3 is a front view ofthe vertical rack assembly 12 highlighting in particular the compactheight of the vertical rack assembly 12 as well as the width componentof the footprint. FIG. 4 is a top view of the vertical rack assembly 12highlighting in particular the overall compact footprint (e.g. width anddepth components) that minimizes operating room floor space that must bededicated to storing surgical instrument trays. FIG. 5 is a side view ofthe vertical rack assembly 12 highlighting in particular the cascadingmultiple angled shelves providing the increased surface area necessaryfor the ergonomic accessibility of all the surgical instruments insideeach instrument tray.

Referring to FIGS. 8-15, the base assembly 18 will now be described infurther detail. As previously mentioned, the base assembly includes asupport structure 24, a shell 26, and a plurality of mobility elements28. FIG. 8 is a plan view of a “triple-wide” vertical rack assembly 12.FIG. 9 is an isometric view of the “triple-wide” vertical rack assembly12 shown without the monitor assembly 22 and the shell 26, illustratingin particular (at least partially) the support structure 24. By way ofexample, the support structure 24 includes a base frame 58, a supportbase 60, and first and second vertical supports 62, 64.

Referring to FIGS. 10 and 11, the base frame 58 includes a lateralsupport beam 66 and a pair of angled support beams 68, 70. The lateralsupport beam 66 is positioned such that it forms the back perimeter ofthe footprint, and includes a mobility element connector 72 at each end.The first angled support beam 68 extends from a first point near themidpoint of the lateral support beam 66 outward toward one of the frontcorners of the footprint at an approximately 60° angle relative to thelateral support beam 66 and includes a mobility element connector 72 atthe distal end. The second angled support beam 70 extends from a secondpoint near the midpoint of the lateral support beam 66 (on the oppositeside of the midpoint from the point of attachment of the first angledsupport beam 68) outward toward the other front corner of the footprintat an approximately 60° angle relative to the lateral support beam 66,and includes a mobility element connector 72 at the distal end.

The support base 60 includes first and second longitudinal support beams74, 76 and a lateral support beam 78. The first longitudinal supportbeam 74 is positioned on one side of the base frame 58 and has aproximal end 80, a distal end 82, a planar top surface 84, and a beveleddistal surface 86. The proximal end 80 is attached to the horizontalsupport beam 66 of the base frame 58, and the distal end 82 is attachedto the first angled support beam 68. The planar top surface 84 isconfigured to mechanically engage a portion of the first verticalsupport 62 to securely maintain the first vertical support 62 in aninety-degree orientation relative to the floor. The beveled distalsurface 86 is configured to mechanically engage a portion of the secondvertical support 64 to securely maintain the second vertical support 64in an angled orientation relative to the floor. The second longitudinalsupport beam 76 is positioned on the opposite side of the base frame 58from the first longitudinal support beam 74 and has a proximal end 88, adistal end 90, a planar top surface 92, and a beveled distal surface 94.The proximal end 88 is attached to the horizontal support beam 66 of thebase frame 58, and the distal end 90 is attached to the second angledsupport beam 70. The planar top surface 92 is configured to mechanicallyengage a portion of the first vertical support 62 to securely maintainthe first vertical support 62 in a 90° orientation relative to thefloor. The beveled distal surface 94 is configured to mechanicallyengage a portion of the second vertical support 64 to securely maintainthe second vertical support 64 in an angled orientation relative to thefloor. By way of example only, this angled orientation may beapproximately 60° however other angles are possible.

Referring to FIGS. 12 and 13, the first vertical support 62 includesfirst and second leg elements 96, 98, and a crossbar 100. The first legelement 96 includes a base 102 that attaches to the planar top surface84 described above. The attachment may be achieved via any suitablemethod for secure attachment, including nut and bolt, pin, welding, andthe like. The second leg element 98 includes a base 104 that attaches tothe planar top surface 92 described above. The attachment may beachieved via any suitable method for secure attachment, including nutand bolt, pin, welding, and the like. The first and second leg elements96, 98 are attached to opposite ends of the crossbar 100. The crossbar100 extends between and attaches to the first and second lateral supportbars 38, 40, described in further detail below. The second verticalsupport 64 includes first and second leg elements 106, 108, and acrossbar 110. The first leg element 106 includes a base 112 thatattaches to the beveled distal surface 86 described above. Theattachment may be achieved via any suitable method for secureattachment, including nut and bolt, pin, welding, and the like. Thesecond leg element 108 includes a base 114 that attaches to the beveleddistal surface 94 described above. The attachment may be achieved viaany suitable method for secure attachment, including nut and bolt, pin,welding, and the like. The first and second leg elements 106, 108 areattached to opposite ends of the crossbar 110. The crossbar 110 extendsbetween and attaches to the first and second lateral support bars 38,40, described in further detail below.

Referring to FIGS. 14 and 15, the shell 26 comprises a thermoformedplastic (by way of example) element that covers the base frame 58 andsupport base 60, to ensure the base assembly 18 is easy to clean whilecreating a stylized design that is impact resistant and pleasing to theeyes with smooth flowing curvature. The shell 26 includes a pair oflateral extensions 116 that cover the distal ends of the lateral supportbeam 66, including the mobility element connectors 72 positionedthereon. The shell 26 further includes a pair of angled extensions 118that cover the distal ends of the first and second angled support beams68, 70, including the mobility element connectors 72 positioned thereon.Additionally, the shell 26 includes a plurality of apertures 120 formedtherethrough to allow for the extension of the various leg elements ofthe first and second vertical supports 62, 64. The apertures 120 eachinclude an escutcheon ring 121 attached thereto. The escutcheon rings121 physically engage the vertical supports 62, 64 and mechanicallyconnect the frame assembly to the vertical supports 62, 64 so that thethermoformed shell 26 does not bear any weight. The shell 26 furtherincludes a front cutaway portion 122 that allows a user to stand closerto the instrument trays, minimizing the need for an operating roomtechnician to endure uncomfortable reaching during a surgical procedure.

The mobility elements 28 may be any suitable mechanism to allow for easymovement (e.g. positioning, transfer, storage, etc) of the vertical rackassembly 12 within an operating room, between operating rooms, and/orbetween a storage room and operating room. Referring again to FIG. 8,and by way of example only, the mobility elements 28 of the currentexample may be lockable swivel casters.

Referring now to FIGS. 16-27, the shelf assembly 20 will be described infurther detail. FIG. 16 illustrates an example of the first shelf 30.The first shelf 30 includes a generally rectangular, planar panel 122that serves as the surface upon which the surgical instrument trays arelocated. A first elongated flange 124 is positioned on one longperimeter edge of the rectangular panel 122 and has a height dimensionextending generally perpendicularly from the panel 122 and a lengthdimension coinciding with the long edge of the rectangular panel 122. Asecond elongated flange 126 is positioned on the opposite long perimeteredge of the rectangular panel 122 and has a height dimension extendinggenerally perpendicularly from the panel 122 and a length dimensioncoinciding with the long edge of the rectangular panel 122. The firstand second elongated flanges function to prevent migration (e.g. forwardand backward) of surgical instrument trays that are placed on the firstshelf 30. By way of example only, the first shelf 30 has a lengthdimension of approximately 68 inches and a width dimension ofapproximately 16 inches. Other length and/or width dimensions arepossible depending upon the size and number of surgical instrument traysrequired by a surgical procedure. For example, the first shelf 30 in the“double-wide” vertical rack assembly 12 shown in FIGS. 2-7 may have alength dimension of approximately 46 inches. In the example shown anddescribed herein, the first shelf 30 comprises the bottom-most shelf onthe vertical rack assembly 12 and has a slightly larger width dimensionthan the other shelves to accommodate larger surgical instrument trays.As can be seen in FIG. 5, the first shelf 30 in the present example isaligned in a generally parallel orientation relative to the operatingroom floor.

FIG. 17 illustrates an example of a second shelf 32. The second shelf 32includes a generally rectangular, planar panel 128 that serves as thesurface upon which the surgical instrument trays are located. A firstelongated flange 130 is positioned on one long perimeter edge of therectangular panel 128 and has a height dimension extending generallyperpendicularly from the panel 128 and a length dimension coincidingwith the long edge of the rectangular panel 128. A second elongatedflange 132 is positioned on the opposite long perimeter edge of therectangular panel 128 and has a height dimension extending generallyperpendicularly from the panel 128 and a length dimension coincidingwith the long edge of the rectangular panel 128. The first and secondelongated flanges 130, 132 function to prevent migration (e.g. forwardand backward) of surgical instrument trays that are placed on the secondshelf 32. By way of example only, the second shelf 32 has a lengthdimension of approximately 68 inches and a width dimension ofapproximately 11 inches. Other length and width dimensions are possibledepending upon the size and number of surgical instrument trays requiredby a surgical procedure. For example, the second shelf 32 in the“double-wide” vertical rack assembly 12 shown in FIGS. 2-7 may have alength dimension of approximately 45.5 inches. In the example shown anddescribed herein, the second shelf 32 comprises the lower middle shelf(of four total shelves) on the vertical rack assembly 12. As can be seenin FIG. 5, the second shelf 32 in the present example is aligned in agenerally non-parallel, angled orientation relative to the first shelf30.

FIG. 18 illustrates an example of the third shelf 34. The third shelf 34includes a generally rectangular, planar panel 134 that serves as thesurface upon which the surgical instrument trays are located. A firstelongated flange 136 is positioned on one long perimeter edge of therectangular panel 134 and has a height dimension extending generallyperpendicularly from the panel 134 and a length dimension coincidingwith the long edge of the rectangular panel 134. A second elongatedflange 138 is positioned on the opposite long perimeter edge of therectangular panel 134 and has a height dimension extending generallyperpendicularly from the panel 134 and a length dimension coincidingwith the long edge of the rectangular panel 134. The first and secondelongated flanges 134, 138 function to prevent migration (e.g. forwardand backward) of surgical instrument trays that are placed on the thirdshelf 34. By way of example only, the third shelf 34 has a lengthdimension of approximately 68 inches and a width dimension ofapproximately 11 inches. Other length and width dimensions are possibledepending upon the size and number of surgical instrument trays requiredby a surgical procedure. For example, the third shelf 34 in the“double-wide” vertical rack assembly 12 shown in FIGS. 2-7 may have alength dimension of approximately 45.5 inches. In the example shown anddescribed herein, the third shelf 34 comprises the upper middle shelf(of four total shelves) on the vertical rack assembly 12. As can be seenin FIG. 5, the third shelf 34 in the present example is aligned in agenerally angled orientation relative to the first shelf 30. By way ofexample, the angle of the third shelf 34 may be different than the angleof the second shelf.

FIGS. 19-20 illustrate an example of the fourth shelf 36. The fourthshelf 36 includes a generally rectangular, planar panel 140 that servesas the surface upon which the surgical instrument trays are located. Afirst elongated flange 142 is positioned on one long perimeter edge ofthe rectangular panel 140 and has a height dimension extending generallyperpendicularly from the panel 140 and a length dimension coincidingwith the long edge of the rectangular panel 140. A second elongatedflange 144 is positioned on the opposite long perimeter edge of therectangular panel 140 and has a width dimension extending angularly awayfrom the panel 134 and a length dimension coinciding with the long edgeof the rectangular panel 134. A third elongated flange 146 is positionedon the opposite long perimeter edge of the second elongated flange 144and has a height dimension extending generally perpendicularly from thesecond elongated flange 146 in a downward vertical direction and alength dimension coinciding with the long edge of the second elongatedflange 144. The first elongated flange 142 functions to preventmigration (e.g. forward) of surgical instrument trays that are placed onthe fourth shelf 36. The second and third elongated flanges 144, 146function to keep bacteria and other surgical debris on the outside ofthe vertical rack assembly 12. By way of example only, the fourth shelf36 (e.g. each component thereof) has a length dimension of approximately68 inches, the rectangular panel 140 has a width dimension ofapproximately 11 inches, and the second elongated flange has a widthdimension of approximately 2 inches. Other length and width dimensionsare possible depending upon the size and number of surgical instrumenttrays required by a surgical procedure. For example, the fourth shelf 36in the “double-wide” vertical rack assembly 12 shown in FIGS. 2-6 mayhave a length dimension of approximately 45.5 inches.

In the example shown and described herein, the fourth shelf 36 comprisesthe upper-most shelf (of four total shelves) on the vertical rackassembly 12. As can be seen in FIGS. 5 and 20, the fourth shelf 36 inthe present example is positioned in such a way that the rectangularpanel 140 is aligned in a generally angled orientation relative to theoperating room floor and the second elongated flange 144 is generallyparallel to the first shelf 30. By way of example, the angle of thefourth shelf 36 may be different than the angle of the third shelf 34and/or the angle of the second shelf 32.

FIGS. 21-22 illustrate the first lateral support panel 38 in greaterdetail. The first lateral support panel 38 comprises a generally planarfirst (e.g. “outer-facing”) surface 148, a second (e.g. “inner-facing”)surface 150, a first (e.g. “front-facing”) side 152 and a second (e.g.“rear-facing”) side 154. The portion of the perimeter of the firstlateral support panel 38 that comprises the front-facing side 152includes a plurality of shelf support flanges oriented in a generally“terraced” manner. For example, the first shelf support flange 156comprises a generally rectangular planar flange extending generallyperpendicularly from the first lateral support panel 38 in the directionof the inner-facing surface 150. The first shelf support flange 156 isoriented generally parallel to the floor and is configured to support afirst end of the first shelf 30 described above. The first shelf supportflange 156 includes a pair of attachment elements 158 located at eitherlongitudinal end of the support flange 156. By way of example, theattachment elements 158 may comprise any suitable attachment mechanism,for example including but not limited to apertures for receiving ascrew, pin, rivet, etc. Optionally, the first lateral support panel 38may include an additional aperture (not shown) for receiving at least aportion of a holder/receptacle configured to receive the portableelectronic device 17 used to interface with the standardization softwareplatform 16 (e.g. tablet computer, smart phone, etc) when not in use.

The second shelf support flange 160 comprises a generally rectangularplanar flange extending generally perpendicularly from the first lateralsupport panel 38 in the direction of the inner-facing surface 150. Thesecond shelf support flange 160 is oriented at a slight angle relativeto the floor and is configured to support a first end of the secondshelf 32 described above. The second shelf support flange 160 includes apair of attachment elements 162 located at either longitudinal end ofthe support flange 160. By way of example, the attachment elements 162may comprise any suitable attachment mechanism, for example includingbut not limited to apertures for receiving a screw, pin, rivet, etc.

The third shelf support flange 164 comprises a generally rectangularplanar flange extending generally perpendicularly from the first lateralsupport panel 38 in the direction of the inner-facing surface 150. Thethird shelf support flange 164 is oriented at a slight angle relative tothe floor and is configured to support a first end of the third shelf 34described above. The third shelf support flange 164 includes a pair ofattachment elements 166 located at either longitudinal end of thesupport flange 164. By way of example, the attachment elements 166 maycomprise any suitable attachment mechanism, for example including butnot limited to apertures for receiving a screw, pin, rivet, etc.

The fourth shelf support flange 168 comprises a generally rectangularplanar flange extending generally perpendicularly from the first lateralsupport panel 38 in the direction of the inner-facing surface 150. Thefourth shelf support flange 168 is oriented at a slight angle relativeto the floor and is configured to support a first end of the fourthshelf 36 described above. The fourth shelf support flange 168 includes apair of attachment elements 168 located at either longitudinal end ofthe support flange 168. By way of example, the attachment elements 170may comprise any suitable attachment mechanism, for example includingbut not limited to apertures for receiving a screw, pin, rivet, etc.

The portion of the perimeter of the first lateral support panel 38 thatcomprises the rear-facing side 154 includes a vertically orientedstraight portion 172 and a horizontally oriented straight portion 174separated by a gradually arcuate portion 176. This arrangement reducesmaterial used and minimizes the weight and bulkiness of the verticalrack assembly 12. The first lateral support panel 38 further includes aplurality of attachment elements 178 (e.g. apertures for receiving ascrew, pin, rivet, and the like) dispersed thereon to enable attachmentof the first and second vertical supports 62, 64, grab handle 48, andthe horizontal panels 42, 44, 46.

FIGS. 23-24 illustrate the second lateral support panel 40 in greaterdetail. The second lateral support panel 40 is essentially a mirrorimage of the first lateral support panel 38 described above. The secondlateral support panel 40 comprises a generally planar first (e.g.“outer-facing”) surface 180, a second (e.g. “inner-facing”) surface 182,a first (e.g. “front-facing”) side 184 and a second (e.g. “rear-facing”)side 186. The portion of the perimeter of the second lateral supportpanel 40 that comprises the front-facing side 184 includes a pluralityof shelf support flanges oriented in a generally “terraced” manner. Forexample, the first shelf support flange 188 comprises a generallyrectangular planar flange extending generally perpendicularly from thesecond lateral support panel 40 in the direction of the inner-facingsurface 182. The first shelf support flange 188 is oriented generallyparallel to the floor and is configured to support a second end of thefirst shelf 30 described above. The first shelf support flange 188includes a pair of attachment elements 190 located at eitherlongitudinal end of the support flange 188. By way of example, theattachment elements 190 may comprise any suitable attachment mechanism,for example including but not limited to apertures for receiving ascrew, pin, rivet, etc. Optionally, the second lateral support panel 40may include an additional aperture (not shown) for receiving at least aportion of a holder/receptacle configured to receive the portableelectronic device 17 used to interface with the standardization softwareplatform 16 (e.g. tablet computer, smart phone, etc) when not in use.

The second shelf support flange 192 comprises a generally rectangularplanar flange extending generally perpendicularly from the secondlateral support panel 40 in the direction of the inner-facing surface182. The second shelf support flange 192 is oriented at a slight anglerelative to the floor and is configured to support a second end of thesecond shelf 32 described above. The second shelf support flange 192includes a pair of attachment elements 194 located at eitherlongitudinal end of the support flange 192. By way of example, theattachment elements 194 may comprise any suitable attachment mechanism,for example including but not limited to apertures for receiving ascrew, pin, rivet, etc.

The third shelf support flange 196 comprises a generally rectangularplanar flange extending generally perpendicularly from the secondlateral support panel 40 in the direction of the inner-facing surface182. The third shelf support flange 196 is oriented at a slight anglerelative to the floor and is configured to support a second end of thethird shelf 34 described above. The third shelf support flange 196includes a pair of attachment elements 198 located at eitherlongitudinal end of the support flange 196. By way of example, theattachment elements 198 may comprise any suitable attachment mechanism,for example including but not limited to apertures for receiving ascrew, pin, rivet, etc.

The fourth shelf support flange 200 comprises a generally rectangularplanar flange extending generally perpendicularly from the secondlateral support panel 40 in the direction of the inner-facing surface182. The fourth shelf support flange 200 is oriented at a slight anglerelative to the floor and is configured to support a second end of thefourth shelf 36 described above. The fourth shelf support flange 200includes a pair of attachment elements 202 located at eitherlongitudinal end of the support flange 200. By way of example, theattachment elements 202 may comprise any suitable attachment mechanism,for example including but not limited to apertures for receiving ascrew, pin, rivet, etc.

The portion of the perimeter of the second lateral support panel 40 thatcomprises the rear-facing side 186 includes a vertically orientedstraight portion 204 and a horizontally oriented straight portion 206separated by a gradually arcuate portion 208. This arrangement reducesmaterial used and minimizes the weight and bulkiness of the verticalrack assembly 12. The second lateral support panel 40 further includes aplurality of attachment elements 210 (e.g. apertures for receiving ascrew, pin, rivet, and the like) dispersed thereon to enable attachmentof the first and second vertical supports 62, 64, grab handle 48, andthe rear panels 42, 44, 46.

FIGS. 25-27 illustrate several examples of filler panels and curtains(e.g. rear panels) that function to close off the design of the verticalrack assembly 12 so that there are minimal bacterial ingress sites aswell as create a rear face that is easy to clean for example withsterilizing solution. FIG. 25 illustrates an example of a first rearpanel 42 configured for positioning behind the grab handle 48 (see e.g.FIG. 3). The first rear panel 42 comprises a generally rectangularplanar member including a pair of attachment flanges 212 each having aplurality of attachment elements 214 (e.g. apertures for receiving ascrew, pin, rivet, and the like) dispersed thereon to enable attachmentto the first and second lateral support panels 38, 40. The first rearpanel 42 further includes an additional flange 216 positioned along oneof the elongated edges to help keep bacteria and other surgical debrison the outside of the vertical rack assembly 12.

FIG. 26 illustrates an example of a second rear panel 44 configured forpositioning behind the first and second shelves 30, 32 (see e.g. FIGS. 3and 7). The second rear panel 44 comprises a generally rectangularplanar member including a pair of attachment flanges 218 each having aplurality of attachment elements 220 (e.g. apertures for receiving ascrew, pin, rivet, and the like) dispersed thereon to enable attachmentto the first and second lateral support panels 38, 40. The second rearpanel 44 further includes an additional attachment elements 222positioned along one of the elongated edges to facilitate attachment tothe third rear panel 46 to create a continuous rear panel.

FIG. 27 illustrates an example of a third rear panel 46 configured forpositioning behind the third and fourth shelves 34, 36 (see e.g. FIGS. 3and 7). The third rear panel 46 includes a first vertically orientedgenerally rectangular planar portion 224, a second vertically orientedgenerally rectangular planar portion 226, and a horizontally orientedgenerally rectangular planar portion 228 extending between the first andsecond vertically oriented portions 224, 226. The first verticallyoriented portion 224 includes a pair of attachment flanges 230 eachhaving a plurality of attachment elements 232 (e.g. apertures forreceiving a screw, pin, rivet, and the like) dispersed thereon to enableattachment to the first and second lateral support panels 38, 40. Thesecond vertical portion 226 includes additional attachment elements 234positioned therein to facilitate attachment to the second rear panel 44to create a continuous rear panel.

FIG. 28 illustrates an example of a vertical rack assembly 12 havingfirst, second, third, and fourth shelves 30, 32, 34, 36 that areconfigured to hold at least one surgical instrument tray (e.g.“single-wide”) per shelf. Such a rack could be used for surgicalprocedures needing few instrument trays.

Referring again to FIGS. 5-7, the monitor assembly 22 will now bediscussed in further detail. FIGS. 5 and 7 show the vertical rackassembly 12 with a monitor assembly 22 attached and in the “in use”position. The monitor 52 can be used to display various aspects of thestandardization software platform 16. The monitor 52 may be equippedwith touch-screen technology enabling direct data input or alternativelythe monitor 52 may be display only. According to one embodiment, thestandardization software platform 16 may be loaded on to a portablecomputer device, for example a portable tablet computer 17 (e.g. FIG.1), smart phone, laptop computer, and the like. In such a case, the userinterfaces with the standardization software platform 16 using theportable computer device, and the monitor displays a mirrored image ofthe display on the portable computer device, using wirelesscommunication technology such as (by way of example) Bluetooth, Airplay,WiFi, and the like.

The monitor 52 is designed with similar curvature as the cascadingshelves while allowing for cord management. The monitor assembly 22 isalso mounted to a pivot bar 50 located well below the top of verticalrack assembly 12 in order to create the necessary room for the sterileidentification barrier 14 behind the vertical rack assembly 12. Themonitor assembly 22 is also designed so that the monitor 52 is above andbehind the top of the vertical rack assembly 12 in order to maintain thevisibility of the monitor 52 during the surgical procedure.

FIG. 6 shows the monitor assembly 22 in a draping position. A pivothandle 56 attached to a rolling cam assembly is used to release themonitor assembly 22 to enable it to pivot about the pivot bar 50 andcreate a greater angle between the monitor 52 and the back plane of thevertical rack assembly 12. The adjustment of the monitor assembly 22allows an unsterile person to drape a sterile monitor cover over themonitor 52 and pivot the monitor assembly 22 back into the “in use”position without breaking sterile protocol. The pivot bar 50 may also beused by a person located outside the sterile field to maneuver thevertical rack assembly 12 into or about the sterile field withoutcontaminating the sterile field. Thus, a person in the sterile fielddoes not have to leave the sterile field to move the vertical rackassembly 12.

Referring now to FIGS. 29-31, an example of a vertical rack assembly 12with an attached X-Ray barrier 236 is described. The X-Ray barrier 236is lined sufficiently in order to limit the penetration of harmfulradiation that is used in an operating room during a surgical procedure.The X-Ray barrier 236 allows any person or persons in the operating roomto shield themselves from the harmful effects of radiation bypositioning themselves such that the X-Ray barrier 236 is betweenthemselves and the radiation source. By way of example, the X-Raybarrier 236 includes a plurality of attachment elements 238 configuredto enable attachment of the X-Ray barrier 236 to the vertical rackassembly 12, and a weight element 240 to ensure that the X-Ray barrier240 is fully extended during the surgical procedure to provide maximumprotection to anyone standing behind it.

Additional examples of vertical shelf assemblies may be found incommonly-owned U.S. Pat. No. 8,074,815 to Gerstner (incorporated byreference) and commonly owned U.S. patent application Ser. No.15/055,280, filed on Feb. 26, 2016, entitled CANTILEVER ORGANIZATIONALRACK SYSTEM FOR SUPPORTING SURGICAL INSTRUMENTATION (incorporated byreference).

FIGS. 32-33 illustrate one example of a sterile identification barrier14 sized for use with a “triple-wide” vertical rack assembly 12 havingfour shelves. By way of example, the sterile identification barrier 14comprises a large sheet 242 of sterile material (e.g. PE) sized andconfigured to overlay the vertical rack assembly 12. The sterileidentification barrier 14 has an upper-facing surface 244 (FIG. 32) anda lower-facing surface 246 (FIG. 33). The upper facing surface 244includes a plurality of thicker tray pads sized and configured forpositioning within the various shelves of the vertical rack assembly 12described above. The thicker tray pads are comprised of a resilientabsorbent material (e.g. PSB 3030 with PE) to facilitate absorption ofliquid as well as prevent perforation of the sterile identificationbarrier 14 due to contact with surgical instruments. The tray pads maybe sized such that a single pad fits within a single shelf, oralternatively the tray pads may be sized such that a single pad coversmore than one shelf. The sterile identification barrier 14 of thepresent example includes a first tray pad 248 and a second tray pad 250.The first tray pad 248 is positioned near one end of the large sheet 242and is configured to cover the third and fourth shelves 34, 36 of thevertical rack assembly 12. The first tray pad 248 includes a firstportion 252 sized and configured to rest within the fourth shelf 36, asecond portion 254 sized and configured to rest within the third shelf34, and a third portion 256 sized and configured to span the gap betweenthe third and fourth shelves 34, 36. The second tray pad 250 ispositioned adjacent to the first tray pad 248 and is sized andconfigured to cover the first and second shelves 30, 32 of the verticalrack assembly 12. The second tray pad 250 includes a first portion 258sized and configured to rest within the second shelf 32, a secondportion 260 sized and configured to rest within the first shelf 30, anda third portion 262 sized and configured to span the gap between thefirst and second shelves 30, 32.

The sterile identification barrier 14 includes a plurality of locationindicia 264 that direct the user to a specific area to place the correctinstrument tray so that the instrument tray is in the same location onvertical rack assembly 12 as it is in the planogram 444 (FIG. 59) on thestandardization software platform 16. The exact number of locationindicia 264 needed is determined by the size and number of shelves onthe vertical rack assembly 12. For example, as noted previously thesterile identification barrier 14 of the instant example is configuredfor use with a “triple-wide” vertical rack assembly 12 having fourshelves. Thus, the vertical rack assembly 12 is configured to hold atotal of twelve instrument trays, and correspondingly the sterileidentification barrier 14 for a “triple-wide” vertical rack assemblyincludes a total of twelve location indicia 264.

In the current example, the location indicia 264 that is located on theleft side of the first portion 252 of the first tray pad 248 (from theperspective of a user looking at the vertical rack assembly 12 withsterile identification barrier 14 employed) has assigned a “1”. Thus theidentification label 264 includes the marking “1” and may becolor-coded. From the user's perspective when looking at the verticalrack assembly 12 with a deployed sterile identification barrier 14, this“position 1” is located in the upper left position, whichcorrespondingly is the same location of “position 1” on the planogram inthe standardization software 16. The identification label 264 that islocated generally in the center of the first portion 252 of the firsttray pad 248 has been assigned to “position 2” and marked with a “2”identifier. The identification label 264 that is located generally onthe right side (from the user's perspective looking at the sterileidentification barrier 14) of the first portion 252 of the first traypad 248 has been assigned to “position 3” and marked with a “3”identifier. In the same fashion, the second portion 254 of the firsttray pad 248 includes three identification labels 264, one each markedwith a “4”, “5”, and “6” identifier, the first portion 258 of the secondtray pad 250 includes three identification labels 264, one each markedwith a “7”, “8”, and “9” identifier, and the second portion 260 of thesecond tray pad 250 includes three identification labels 264, one eachmarked with a “10”, “11”, and “12” identifier.

The location indicia 264 may take any form that quickly and easilyconveys information to a user, including but not limited to letters,numbers, symbols, shapes, colors, and/or words, alone or in combination.According to one example, different colors may be used to indicate whichshelf a specific instrument is located on. For instance, the locationindicia 264 positioned in the first portion 252 of the first tray pad248 may be sequentially numbered 1, 2, 3 and may also be blue in color,while the location indicia 264 positioned within the second portion 254of the first tray pad 248 may be sequentially numbered 4, 5, 6 and mayalso be red in color, and so on. In some instances, for example whenmultiple vertical rack assemblies 12 are in use for the same surgicalprocedure, a location indicia 264 may be a combination of numbers andletters (e.g. A1, A2, A3 . . . ) in addition to being color-coded asdescribed above. By way of example only, the location indicia 264 on thesterile identification barrier 14 of the instant example comprise labelscontaining sequential numbers (e.g. 1, 2, 3 . . . 12). It is importantfor the correct tray to be associated with a specific identificationlabel 264, so that the information is coordinated with preset planogramof the standardized software platform 16. To help ensure this outcome,matching location-indicia labels, tags or clips may be affixed to theinstrument trays once a tray is assigned a location in the planogram 444during initial setup (see, e.g. FIG. 36).

The sterile identification barrier 14 further includes a plurality ofcoated wires 266 mounted partially on the large sheet 242 and partiallyon portions of the tray pads 248, 250. The coated wires 266 can bemanipulated in order to conform the sterile identification barrier 14 tovertical rack assembly 12 and secure the positioning of the tray pads248, 250 and/or tray pad portions 252, 254, 258, 260 within therespective shelves 36, 34, 32, 30. More specifically, the coated wires256 are bendable so that once a particular tray pad or tray pad portionis positioned within the correct shelf on the vertical rack assembly 12(for example tray pad portion 252 positioned over fourth shelf 36) thegroup of four coated wires 264 immediately adjacent to the tray padportion 252 (two coated wires 264 on each side of the tray pad portion)are bent around the lateral edge of the fourth shelf 36, thus securingthat portion of the sterile identification barrier 16 to the verticalrack assembly 12.

The sterile identification barrier 14 may include additionalanti-migration features 268 (e.g. hook-and-loop fasteners) positioned onthe lower facing surface 246 that interact with correspondinganti-migration features (not shown) on the vertical rack assembly 12 tohelp prevent shifting of the sterile identification barrier 14 duringuse. Additionally, a plurality of adhesive strips 270 placed about theperimeter of the sterile identification barrier 14 on both theupper-facing surface 244 and lower-facing surface 246 may be used toreduce any stack that might occur when the sterile identificationbarrier 14 is employed on the vertical rack assembly 12. A portion ofmaterial at the top of the sterile identification barrier 14 is foldedover and heat-sealed to create a cuff 272 that fits over the back of thevertical rack assembly 12. The sterile identification barrier 14 mayfurther include additional visual indicators to help direct users in theproper way to unfold the sterile identification barrier 14. For example,a pair of visual indicators 274 (e.g. hand icons) may be positioned onthe cuff 272 (on the lower-facing surface 246) to indicate to a user theproper spot for placement of hands during the unfolding process. Anothervisual indicator 276 (e.g. downward pointing arrow) may be positioned onthe upper-facing surface 244 at the opposite end of the large sheet 242from the cuff 272, indicating the direction in which the user mustunfold that portion of the folded sterile identification barrier 14.Additional visual indicators 278 (right-pointing arrow), 280(left-pointing arrow) and 282 (U-shaped arrow) are positioned on thelower-facing surface 246 and perform similar functions to that of thevisual indicator 276.

FIGS. 34-35 illustrate an example of a sterile identification barrier 14a sized for use with a “double-wide” vertical rack assembly 12 havingfour shelves. The sterile identification barrier 14 a of the instantexample is virtually identical with respect to features and function asthe sterile identification barrier 14 described above in relation toFIGS. 32-33 except that the overall size is smaller to accommodate asmaller “double-wide” vertical rack assembly 12 and the sterileidentification barrier 14 a of the instant example comprises a total ofeight location indicia 306.

The sterile identification barrier 14 a comprises a large sheet 284 ofsterile material (e.g. PE) having an upper-facing surface 286 (FIG. 34)and a lower-facing surface 288 (FIG. 35). The upper facing surface 288includes a plurality of thicker tray pads sized and configured forpositioning within the various shelves of the vertical rack assembly 12described above. The thicker tray pads are comprised of a resilientabsorbent material (e.g. PSB 3030 with PE) to facilitate absorption ofliquid as well as prevent perforation of the sterile identificationbarrier 14 a due to contact with surgical instruments. The tray pads maybe sized such that a single pad fits within a single shelf, oralternatively the tray pads may be sized such that a single pad coversmore than one shelf. The sterile identification barrier 14 a of thepresent example includes a first tray pad 290 and a second tray pad 292.The first tray pad 290 is positioned near one end of the large sheet 284and is configured to cover the third and fourth shelves 34, 36 of thevertical rack assembly 12. The first tray pad 290 includes a firstportion 294 sized and configured to rest within the fourth shelf 36, asecond portion 296 sized and configured to rest within the third shelf34, and a third portion 298 sized and configured to span the gap betweenthe third and fourth shelves 34, 36. The second tray pad 292 ispositioned adjacent to the first tray pad 290 and is sized andconfigured to cover the first and second shelves 30, 32 of the verticalrack assembly 12. The second tray pad 292 includes a first portion 300sized and configured to rest within the second shelf 32, a secondportion 302 sized and configured to rest within the first shelf 30, anda third portion 304 sized and configured to span the gap between thefirst and second shelves 30, 32.

As with the sterile identification barrier 14 described above, thesterile identification barrier 14 a includes a plurality of locationindicia 306 that direct the user to a specific area to place the correctinstrument tray so that the instrument tray is in the same location onvertical rack assembly 12 as it is in the planogram 444 on thestandardization software platform 16. The location indicia 306 may takeany form that quickly and easily conveys information to a user,including but not limited to letters, numbers, symbols, shapes, colors,and/or words, alone or in combination. The sterile identificationbarrier 14 a shown by way of example in FIG. 34 includes alphanumericlocation indicia 306 to create differentiation in a case where there aremultiple vertical rack assembly 12 units in the same operating room. Forexample, the location indicia 306 of the instant example are labeled“B1, B2, B3 . . . B8” to differentiate from another vertical rackassembly 12 in the room (which may be labeled “A1, A2, A3 . . . A12” forexample).

As with the sterile identification barrier 14, the sterileidentification barrier 14 a further includes a plurality of coated wires308 mounted partially on the large sheet 284 and partially on portionsof the tray pads 290, 292. The coated wires 308 can be manipulated inorder to conform the sterile identification barrier 14 a to verticalrack assembly 12 and secure the positioning of the tray pads 290, 292and/or tray pad portions 294, 296, 300, 302 within the respectiveshelves 36, 34, 32, 30 in the manner described above. The sterileidentification barrier 14 a may also include additional anti-migrationfeatures 310 (e.g. hook-and-loop fasteners) positioned on the lowerfacing surface 288 that interact with corresponding anti-migrationfeatures (not shown) on the vertical rack assembly 12 to help preventshifting of the sterile identification barrier 14 a during use.Additionally, a plurality of adhesive strips 312 placed about theperimeter of the sterile identification barrier 14 a on both theupper-facing surface 286 and lower-facing surface 288 may be used toreduce any stack that might occur when the sterile identificationbarrier 14 a is employed on the vertical rack assembly 12. A portion ofmaterial at the top of the sterile identification barrier 14 a is foldedover and heat-sealed to create a cuff 314 that fits over the back of thevertical rack assembly 12. The sterile identification barrier 14 a mayfurther include additional visual indicators to help direct users in theproper way to unfold the sterile identification barrier 14 a. Forexample, a pair of visual indicators 316 (e.g. hand icons) may bepositioned on the cuff 314 (on the lower-facing surface 288) to indicateto a user the proper spot for placement of hands during the unfoldingprocess. Another visual indicator 318 (e.g. downward pointing arrow) maybe positioned on the upper-facing surface 286 at the opposite end of thelarge sheet 284 from the cuff 314, indicating the direction in which theuser must unfold that portion of the folded sterile identificationbarrier 14 a. Additional visual indicators 320 (right-pointing arrow),324 (left-pointing arrow) and 326 (U-shaped arrow) are positioned on thelower-facing surface 288 and perform similar functions to that of thevisual indicator 318.

FIG. 36 illustrates an example of a vertical rack assembly 12 having asterile identification barrier 14 and a plurality of surgical instrumenttrays 19 deployed thereon. The vertical rack assembly 12 is a“double-wide” rack, where each shelf can hold at least two instrumenttrays 19. The instrument trays 19 of the instant example each includelocation indicia labels 265 affixed thereto that correspond with thelocation indicia of the sterile identification barrier 14 and theassigned location in the planogram. The location indicia 265 of theinstant example comprise labels including sequential numbers (e.g. 1, 2,3 . . . 8). It is important for the correct tray to be associated with aspecific identification label 265, so that the information iscoordinated with preset planogram of the standardized software platform16.

FIGS. 37-50 illustrate the sequence of folding an example sterileidentification barrier 14 (and/or 14 a) so that the process of unfoldingand draping a vertical rack assembly 12 does not break the sterileprotocol or risk any contamination before, during and after a surgicalprocedure. The folding process includes a total of twenty specific foldsF₁-F₂₀ in made in sequential order. FIG. 37 depicts one example of asterile identification barrier 14 having a front-facing surface 286, aback-facing surface 288, a top edge 325, bottom edge 327, left edge 329,and right edge 331 laying flat and ready to be folded. The first fold F₁is made by folding the bottom edge 327 back over the sterileidentification barrier 14 along line 1-1. The second fold F₂ is made byfolding the first fold F₁ back under the sterile identification barrier14 along line 2-2.

FIG. 38 depicts the example sterile identification barrier 14 after thefirst and second folds F₁, F₂ have been made. The third fold is made byfolding the second fold F₂ up over line 3-3. FIG. 39 depicts the examplesterile identification barrier 14 after the third fold F₃ has been made.The fourth fold F₄ is made by folding the top edge 325 back over the nowfolded stack along the line 4-4. The fifth fold F₅ is made by foldingthe top edge 325 back over the folded stack along the line 5-5. Thesixth fold F₆ is made by folding the top edge 325 back over the foldedstack along the line 6-6. The seventh fold F₇ is made by folding the topedge 325 back over the folded stack along the line 7-7.

FIG. 40 depicts the example sterile identification barrier 14 after theseventh fold F₇ has been made. As depicted in the drawing (which is notnecessarily to scale), at this point the top edge 325 of the sterileidentification barrier 14 is even with the first fold F₁ and fourth foldF₄. The eighth fold F₈ is made by folding the cuff 314 inside out andthen flipping the front edge of the cuff 314 up to reveal visualindicators 316 (e.g. hand prints icons) that communicate to the userwhere to place their hands when unfolding the sterile identificationbarrier 14. The partially folded sterile identification barrier 14 nowshould appear as depicted in FIG. 41. The ninth fold F₉ is made byfolding the bottom edge 327 up and over the entire stack along the line9-9 so that the portion that was just folded is on top of the stack. Thetenth fold F₁₀ is made by folding the bottom edge 327 back over the topof the stack along line 10-10 so that visual indicator 318 (e.g.downward pointing arrow) is visible on the top of the folded stack.

At this point in the folding process, the semi-folded sterileidentification barrier 14 should look as depicted in FIG. 42, which alsoshows the folding lines for the next group of folds. The eleventh foldF₁₁ is made by folding the left edge 379 back over the top of the stack(to the right) along line 11-11. The twelfth fold F₁₂ is made by foldingthe left edge 379 back over the top of the stack (to the left) alongline 12-12. The thirteenth fold F₁₃ is made by folding the left edge 379back over the top of the stack (to the right) along line 13-13. Thefourteenth fold F₁₄ is made by folding the left edge 379 back over thetop of the stack (to the left) along line 14-14. The fifteenth fold F₁₅is made by folding the left edge 379 back over the top of the stack (tothe right) along line 15-15 so that the visual indicator 320 (e.g. leftfacing arrow) is on the top of the folded stack.

At this point in the folding process the semi-folded sterileidentification barrier 14 should look as depicted in FIG. 43, which alsoshows the folding for the last group of folds. The sixteenth fold F₁₆ ismade by folding the right edge 331 back over the top of the stack (tothe left) along line 16-16. The seventeenth fold F₁₇ is made by foldingthe right edge 331 back over the top of the stack (to the right) alongline 17-17. The eighteenth fold F₁₈ is made by folding the right edge331 back over the top of the stack (to the left) along line 18-18. Thenineteenth fold F₁₉ is made by folding the right edge 331 back over thetop of the stack (to the right) along line 19-19. The twentieth fold Flois made by folding the right edge 331 back over the top of the stack (tothe left) along line 20-20 so that the visual indicator 322 (e.g. leftfacing arrow) and the visual indicator 324 (U-shaped arrow) are on thetop of the folded stack, as shown in FIGS. 44-45.

FIGS. 46-50 illustrate an example of a process of folding an outer wrap335 around the folded sterile identification barrier 14. By way ofexample, the outer wrap may be square-shaped with each side beingapproximately 100 cm in length. However other sizes are possible. To setup the outer wrap 335 and folded sterile identification barrier 14 forfolding, the outer wrap 335 is first arranged in a diamond shape withthe folded sterile identification barrier 14 placed horizontally in thecenter of the diamond shape with the visual indicator 322 (e.g. arrow)pointed up. The outer wrap 335 has a first corner 337 positioned to theright of the sterile identification barrier 14 in the instant example, asecond corner 339 positioned below the sterile identification barrier14, a third corner 341 opposite the second corner 339, and a fourthcorner 343 opposite the first corner 337.

By way of example, the first group of folds may be made by folding thefirst corner 337 toward the sterile ID barrier 14 along line 1-1 andthen folding the first corner 337 away from the sterile ID barrier 14along line 2-2. The next group of folds may be made by folding thesecond corner 339 toward the sterile ID barrier 14 along line 3-3 inFIG. 47 and then folding the second corner 339 away from the sterile IDbarrier 14 along line 4-4. The next group of folds may be made byfolding the third corner 341 toward the sterile ID barrier 14 along line5-5 in FIG. 48 and then folding the third corner 341 away from thesterile ID barrier 14 along line 6-6. The last group of folds may bemade by folding the fourth corner 343 toward the sterile ID barrier 14along line 7-7 in FIG. 49 and then folding the fourth corner 343 awayfrom the sterile ID barrier 14 along line 8-8. The end result is anouter wrap 335 folded about the sterile identification barrier 14 asdepicted in FIG. 50. When folded correctly, a visual indicator 345 (e.g.arrow) shows on top of the stack.

FIG. 51 shows a folded sterile identification barrier 14 wrapped withinan outer wrap 335 and sealed within a sterile package 326. To secure thesterile identification barrier 14 to the vertical rack assembly 12 (e.gthe “draping” process), the above steps are essentially performed in thereverse order. By way of example, draping requires two users tocomplete, for example a circulating nurse and a scrub tech working incooperation. As a first step, one person (e.g. circulating nurse) opensthe sterile packaging, and centers the folded sterile identificationbarrier 14 (in the outer wrap 335) on the first shelf 30 with the arrowpointing away from them. Next the outer wrap 335 is unfolded. At thispoint, the folded sterile identification barrier 14 is exposed. The sameperson grabs the visual indicator 322 (e.g. right-facing arrow) andunfolds the sterile identification barrier 14 over the side of thevertical rack assembly 12. The other person (e.g. scrub tech) the grabsthe visual indicator 320 (e.g. left-facing arrow) and unfolds thesterile identification barrier 14 over the opposite side of the verticalrack assembly 12. One person (e.g. circulating nurse) the grabs thesterile identification barrier 14 on both sides of the visual indicator318 (e.g. downward arrow), and pulls it down over the front of thevertical rack assembly 12. The other person (e.g. scrub tech) securesthe sterile identification barrier 14 by folding the coated wires 308around the edges of the vertical rack assembly 12. The same personplaces their hands underneath the cuff 314, directly beneath the visualindicators 316 (e.g. hand prints), and lifts the sterile identificationbarrier 14 up and over the vertical rack assembly 12. The sterileidentification barrier 14 is secured to the top level (e.g. fourth shelf36) of the vertical rack assembly 12 using the coated wires 308. Next,the coated wires 308 are secured on the next level down (e.g. thirdshelf 34), as are the hook and loop fasteners 310 connecting the sterileidentification barrier 14 to the vertical rack assembly. This process isrepeated for all of the levels of the vertical rack assembly 12 untilfinished. The vertical rack assembly 12 is now ready to be set up withinstrument trays according to the preselected planogram arrangement.

FIG. 52 displays a sterile monitor cover 328 sized and proportioned tofit over the monitor assembly 22 and extend downward past the upper mostplane of vertical rack assembly 12. The sterile monitor cover 328 ismanufactured from a single piece of clear material to maintainvisibility of the monitor 52 when draped. The top edge 330 is heatsealed to create an enclosed bag with the bottom edge 332 having anelastic band 334 that cinches around the monitor assembly 22. Thesterile monitor cover 328 may be stand-alone or alternatively may beattached or integrally formed with the sterile identification barrier14. A smaller version of the sterile monitor cover 328 may be providedas a cover for the portable electronic device 17 (e.g. tablet computer,smart phone, etc) that is used to interface with the standardizationsoftware platform 16.

FIG. 53 illustrates a sterile clear cover 336 that can be used to covera vertical rack assembly 12 and sterile identification barrier 14 whenit is loaded with surgical instrument trays. The sterile clear cover 336allows a user to maximize the sterility of instrumentation that may notbe needed during the first portion of a surgical procedure. Anattachment device such as but not limited to adhesive strips, Velcro ora draw string 338 around the perimeter of the sterile clear cover 336helps to conform and maintain the correct position on the vertical rackassembly 12 until the user needs to remove the sterile clear cover 336and use the surgical instruments that have maintained maximum sterility.By way of example, the sterile clear cover 336 may be employed forpre-setup racks that may be simply rolled into the operating room readyto use as soon as the disposable cover 336 is removed.

The surgical tray efficiency system 10 described herein is an integratedworkflow management system designed to help perioperative staffstandardize and improve their processes. While the efficiency gainsmanifest themselves during the surgical procedure, the groundwork islaid during the setup process. The setup process has two main goals:first, to ensure that all instruments needed for the surgery are presentand accounted for, and second, to arrange the various instrument traysaccording to the planogram functionality such that their location isappropriate and optimized for all stakeholders.

FIG. 54 depicts a flowchart 340 that lays out the framework and logicflow of the standardization software platform 16. The flowchartdescribes how data is input, used, changed and stored for a givensurgical procedure. A goal of the standardization software platform 16is to increase efficiency in the operating room environment by creatingand employing a planogram for a given procedure that can be customizedto suit a particular surgeon's needs and stored for future use. As usedin this disclosure, a “planogram” is an interactive digital display ofrepresentations of surgical instrument trays arranged on a vertical rackassembly 12 for a given procedure, that also provides additionalrelevant information pertaining to the various instruments in each tray.

Initially, a user will engage the standardization software platform 16to determine whether there is a pre-existing, approved planogram for agiven procedure (342) that is accessible from direct access localstorage 344 (e.g., memory that is contained within the computing systemthat includes the display), external storage 346 (e.g. magnetic disk ornon-volatile memory), or cloud storage 348 (e.g., at one or more remotecomputing systems). If the answer is “no”, then the user must formulatea baseline planogram for the given procedure (350). This includesdigitally arranging the instruments and/or trays on a user interfaceusing location ID (e.g. tray tags, stickers, digital location, and thelike), creating and/or retrieving support media that pertain to specificinstruments, sets, trays, or surgeons (e.g. videos, surgical techniques,marketing material, etc), and creating and/or retrieving notes thatpertain to specific instruments, sets, trays, and/or surgeons. To createthis initial formulation, the user can access materials/data from avariety of sources. Examples of data that might be “backend” available(e.g. preloaded or available for download via the Internet) includemanufacturer instrument set specifics 352, surgeon preference lists 354,procedure-specific requirements 356, and other relevant documents/videosfor a given procedure 358. The user can also import digitized card dataabout the specific procedure 360 and/or surgery specific sequential data362 into the planogram. Another building block of the baseline planogramis the capture and/or retrieval of images (364). An important aspect ofthe planogram is the use of images to give a user a near-instant visualrecognition of an instrument. The planogram can be loaded with any imagethe user might find useful, including but not limited to entireinstrument trays, specific isolated instruments, and the like. Notably,the user is able to use the portable computer device's camera tomanually capture images in addition to retrieving vendor specific imagesfrom local or cloud storage. The user may also manually input any otheruseful information about a given procedure into the planogram (366).

After initial setup of the planogram occurs, or if the answer to theinitial question of whether there is a pre-existing approved planogram(342) is “yes”, the planogram is reviewed to determine whether theplanogram is appropriate for all stakeholders (360). “Stakeholders” inthis instance may include the specific doctor, hospital, and operatingroom technicians (including so-called “scrub-techs”) that may be usingthe planogram software during the surgery. If the planogram isdetermined to be inadequate for any of the stakeholders, then the usermay manually input a planogram update (370) and/or reformat theplanogram to appease all stakeholders (372). “Appropriate” meansacceptable and/or optimized for any of the various stakeholders,including most notably the surgeon(s) responsible for performing thesurgery and the OR scrub technician(s) responsible for locating andhanding the various surgical instruments (and implants, if applicable)to the surgeon(s) during the actual surgery. These steps may include(but are not limited to) changing the location of instrument trays,changing the accessible data regarding instruments or trays, updatingadditional notes pertaining to the surgery, etc.

Once the planogram is appropriate for all the stakeholders, the nextstep (374) is to use the planogram based software 16 connected to thevertical rack assembly 12 to increase efficiency for all stakeholdersthroughout the lifecycle of instrumentation use for a given procedure.This involves using the app on the portable device (376), the verticalrack (378), and the location ID (380). More specifically, the portabledevice app 376 is used interactively during the course of the surgicalprocedure to view and/or input notes, videos, images, and/or preferencescorresponding to specific instruments, sets, trays, and/or locations onthe vertical rack 12. The portable device app is also used to locateinstruments, sets, and/or trays using the location ID function and/orsearch function to find a specific location for an instrument or traythat correlates to the vertical rack 12 and/or sterile identificationbarrier 14. The vertical rack 12 display corresponds to a position onthe specific location IDs in the portable device app planogram.Additionally, as previously mentioned the portable device app planogrammay be mirrored onto the display monitor attached to the vertical rack(or operating room wall, moveable stand, etc) so that multiple people inthe room can view the user interface of the planogram at the same time.The location ID 380 pertains to the instrument tray labels, which alsocorrespond to the device app planogram to ensure that the instrumenttray is in the correct location.

After the procedure is completed, the user may review the procedurenotes to determine whether any changes were made to the planogram at anypoint during the procedure cycle (382). If the answer is “Yes” then theplanogram should be evaluated with all the stakeholders of a givenprocedure to harvest ideas for potential improvements (384), and theagreed-upon changes should be made so that the planogram is ready thenext time the specific surgery is performed. Once this is completed (orif the answer to the previous question (382) was “No”), the planogramfor the given procedure should be stored (386) using at least one ofdirect access local storage 344, external storage 346 (e.g. magneticdisk), or cloud storage 348.

FIGS. 55-76 illustrate various graphic user interface (GUI) screens thatan electronic device may present and that a user may encounter whileusing the standardization software platform 16 before, during, and/orafter a surgical procedure. The surgical tray efficiency system 10 iscompatible with any loaner, consigned, or facility-owned trays. Thesetup process generally occurs in a designated area for vendorrepresentatives (e.g. for loaner or consigned trays) or hospital staff(e.g. for facility-owned) to assemble and check the surgical instrumentsand trays. The setup begins with a user (e.g. vendor representative orhospital staff) logging into the standardization software platform 16located on a portable electronic device 17 (e.g. tablet computer orsmart phone) having a touch-screen interface or laptop computer. FIG. 55illustrates an example of an initial login screen 388 that verifies thename of the program and includes a name field 390 for the user to inputtheir name and a password field 392 for the user to input their passwordto gain access to the software. By way of example, tapping on either thename field 390 or the password field 392 causes the electronic device topresent a popup virtual keyboard (not shown), enabling the user to inputthe required information. After populating the name field 390 andpassword field 392 with the correct information, the user presses the“Sign In” button 394 (e.g., by contacting a location on the display atwhich the electronic device presents the “Sign In” button 394). Thecomputer verifies the authentication data against a list of registeredusers and if the authentication data matches, the computer advances theuser to the next screen.

Once the user has successfully logged into the standardization softwareplatform 16, he or she is directed to the home screen 396 (FIG. 56),which the electronic device 17 presents in response to determining thatcorrect authentication data was entered. The display of the home screen396 includes a “Procedures” button 398, an “Enter procedures” button400, an information bar 402, and a default menu bar 404. If the imminentsurgical procedure is one that has a preexisting planogram already setup, or if the user is unsure whether there is a preexisting planogramfor the given surgical procedure, then the user may press the“Procedures” button 398 which prompts the computer to direct the user tothe Procedures screen 418 (FIG. 57). If the imminent surgical procedureis not found in the list of procedures on the Procedures screen 418, orif the user knows that the imminent procedure has not been performedpreviously using the surgical tray efficiency system 10 of the presentdisclosure, then the user will press the “Enter procedure” button 400,which causes the computer to prompt the user to the Enter Procedurescreen 426 (FIG. 58), from which point the user can input the necessaryinformation to start the process of generating a planogram for theimminent surgical procedure.

The information bar 402 is present at the top of most of the GUI screensin the app and displays information pertinent to the surgical procedure,as well as a drop-down menu 406 that will be discussed below inconjunction with FIG. 69. The default menu bar 404 is positioned at thebottom of the screen and also appears on most of the GUI screens in theapp. By way of example, the default menu bar 404 includes a plurality ofpermanent “radio” buttons that prompt the computer to direct the user toa specific GUI screen when pressed. By way of example only, the defaultmenu bar 404 includes a “home” button 408, a “planogram” button 410, a“video media” button 412, a “print media” button 414, and a timemanagement button 416. Pressing the “home” button 408 prompts thecomputer to direct the user to the “home screen” 396 (which in theinstant example may merely refresh the page since the user is on thehome screen 396 already). Pressing the “planogram” button 410 promptsthe computer to direct the user to the planogram screen 442 (FIG. 59).Pressing the “video media” button 412 prompts the computer to direct theuser to the Video Library screen 564 (FIG. 73). Pressing the “printmedia” button 414 prompts the computer to direct the user to theProcedure Library screen 568 (FIG. 74). Pressing the “time managementbutton” 416 prompts the computer to direct the user to the TimeManagement Screen 576 (FIG. 76).

Discussion herein of users pressing buttons and being directed by thecomputer to different screens includes the computer determining thatuser input was received at a location that corresponds to a display of aparticular user interface element (e.g., a “button”) and in response,and sometimes without receipt of further user input, transitioning thedisplay of the computer from a first user interface screen to a seconduser interface screen.

FIG. 57 illustrates an example of the “Procedures” screen 418. By way ofexample, the Procedures screen 418 displays a plurality of procedure IDwindows 420 that each display the identifying information for thespecific surgical procedures that have preexisting planograms associatedtherewith. Each procedure ID window 420 includes information such ashospital name, rack set up, surgeon name, procedure name, and vendorname, however any useful information about a given procedure may bedisplayed. The procedure ID window 420 may also include the hospitallogo, a “reset” button 422, and a “start procedure” button 424. Pressingthe “reset” button 422 prompts the computer to reset an associatedplanogram that may be “checked in” already (e.g. FIG. 70) to “notchecked in”, thereby requiring the user to start the planogramverification process over again. As will be explained, instrument traysare “checked in” on the planogram when they are physically placed on thevertical rack 12 in the operating room. Thus, once all trays are checkedin, the standardization software platform 16 (also referred to as “App”)is ready for the procedure is ready to begin. Thus by pressing the“reset” button 422, the user is essentially telling the computer thatthe procedure is not yet ready to begin. Once the vertical rack 12 isset up and the procedure is ready to begin, the user may press the“start procedure” button 424, which tells the computer that the surgicalprocedure has begun. At this point, the computer may start a runningtimer to record the overall time necessary to complete the procedure, aswell as collect/record other procedure-related data. In addition, theuser is directed to the verified planogram screen 546 (FIG. 70) so thatthe user may use any of the interactive intraoperative features of theapp 16.

FIG. 58 illustrates an example of an Enter Procedure screen 426, towhich a user is directed if a planogram needs to be set up for theimminent surgical procedure (e.g. prior to the first occurrence of asurgical procedure at a certain hospital, or to create a template). Onthis screen, the user can select various identifying information relatedto the imminent surgical procedure from a plurality of prepopulateddropdown menus. For example, the Enter procedure screen 426 includes ahospital menu 428, procedure menu 430, rack set up menu 432, surgeonmenu 434, and company/vendor menu 436. The various dropdown menus arepopulated ahead of time whenever a new specific surgical procedure isscheduled. The user can also indicate whether there is a mayo standsetup by engaging a toggle 438. By way of example only, the mayo standtoggle 438 has a default setting of “ON”, so in practice the user woulddeselect the toggle 438 if a mayo stand is not going to be used (or usedin conjunction with the App 16). Once this information has beenpopulated, the user presses the “Case Setup” button 440 to advance tothe next screen to populate the digital planogram 444.

FIG. 59 illustrates an example of a blank planogram screen 442 that thecomputer will direct the user to when the user presses the “Case Setup”button 440 on the previous screen. In addition to the information bar402 at the top of the screen (which by way of example only may nowdisplay various identifying information related to the specificprocedure, including but not limited to hospital name and logo, surgeonname, procedure name, instrument vendor, and the like) and the defaultmenu bar 404 at the bottom of the screen, the blank planogram screen 442displays the interactive digital planogram 444 that corresponds to thelocation ID on the vertical rack assembly 12 (e.g., which may indicate atype of rack assembly 12 and thus its dimensions and available traylocations) and sterile identification barrier 14 (e.g., which mayindicate the types and order of the location indicia previouslydiscussed). By way of example, the blank planogram screen 442 includes arack tab 446, a mayo stand tab 448, a surgery preference notes tab 452,and a plurality of interactive location windows 454. The rack tab 446and mayo stand tab 448 toggle the user between the planogram setupscreen for the rack (shown by way of example in FIG. 59) and a similarsetup screen 558 for the mayo table (see FIG. 72 and associateddescription).

Each interactive location window 454 includes an image display 456,location ID label 458, and a verification toggle 460. In the currentexample screen, the image display 456 is blank because the user has notset anything up as of yet in the process. The location ID labels 458correspond directly to the location indicia 264 of the sterileidentification barrier 16 and the location indicia 265 affixed to thesurgical instrument trays 19 as previously described, and is based uponthe number of tray locations for the given vertical rack assembly 12 andsterile identification barrier 16. The discussion of location indicia264 in relation to the sterile identification barrier 16 is fullyapplicable to the location ID labels 458 and will not be repeated. Inthe instant example, the vertical rack assembly 12 in use is a“triple-wide” rack, which includes 4 shelves each capable of holding atleast 3 instrument trays. Thus a total of twelve location windows 454are present in the example planogram described herein. It should beunderstood that differently-configured vertical rack assemblies (e.g.“double-wide”, “single-wide” or other configurations) would requiredigital planograms 444 that have a different number of interactivelocation windows 454. By way of example, the interactive locationwindows 454 include location ID labels that are sequentially numbered 1,2, 3 . . . 12. The verification toggle 460 may be pressed once the userfully populates the digital planogram 444 and the correspondinginstrument trays are placed in the correct locations on the verticalrack assembly 12. This may then change the visual indicator associatedwith the verification toggle to indicate that the trays are verified as“checked in” for example from an “x” visual indicator that symbolizes“not checked in” to a check mark indicator that symbolizes “checked in.”

To begin populating the interactive location windows 454, the userchooses a window and provides user input to select the window (e.g., bytapping on it with a finger or stylus or clicking on it with a mouse).This prompts the computer to direct the user to the tray view screen 462for that particular tray location. FIGS. 60-66 illustrate an example ofa tray view screen 462 (FIG. 60) and some of the various features thatare accessible through the tray view screen (FIGS. 61-66).

Referring first to FIG. 60, the tray view screen 462 is an interactivescreen where the user can input and subsequently view data and mediaassociated with a particular instrument tray 19 (or any other item thatis located in the specific location ID spot). By way of example, thetray view screen 462 includes input fields for the tray name 464, trayID 466, and tray notes 468. The tray name field 464 is customizable inthat the user may choose the name for the tray, which for example may bewhatever the specific surgeon chooses to call the tray. The tray ID 466refers to the specific tray serial number (useful for instrumenttracking), which may be manually entered or entered via RFID scan, forexample. The tray notes field 468 may be used to input any additionalnotes that may be useful pertaining to a specific instrument tray, suchas notes pertaining to surgeon preferences, alternate terminology,missing/broken instruments, etc.

The tray view screen 462 further includes a tray image window 470,interactive instrument list 472, and a menu bar 474 on top of the screenthat includes a tray identifier 476, tray verification indicator 478, an“add instrument” button 480, “trays” button 482, “video” button 484, anda “close” button 486. The tray image window 470 may be populated with animage of the instrument tray (or whatever else might be in thatparticular planogram location if not an instrument tray). To populatethe tray image window 470 (or change the current image), the userpresses a “camera” icon 488 positioned adjacent the tray image window470, which causes a popup image selection menu 490 to appear (FIG. 61).On the popup image selection menu 490, the user can select to obtain animage using the device's own camera 492, view a local image library 494,or search the cloud 496 for an image. Once the tray image window 470 ispopulated, tapping on the image itself prompts the computer to activatethe “zoom view” 512, which comprises an enlarged image of the instrumenttray (FIG. 60).

To add data (e.g. photo, video, notes, name, etc) about an instrument tothe tray view screen 462, a user taps on the “add instrument” button 480in the top menu bar 474 or alternatively taps in the interactiveinstrument list area 472. Referring now to FIG. 63, either actionprompts the computer to open the instrument view window 498 over theportion of the tray view screen 462 that includes the tray name 464, ID466 and notes 468, and create an interactive instrument ID tag 499 inthe interactive instrument list 472. (Subsequently, pressing on aninteractive instrument ID tag 499 will open the particular instrumentview window 498 for that instrument). The instrument view widow 498includes an instrument name field 500, instrument ID field 502, andinstrument notes field 504. The user may input any name for theparticular instrument that they want, but it should be noted that thename in the instrument name field 500 is the name that is searchable bythe app 16. The instrument ID 502 refers to the specific instrumentserial number (useful for instrument tracking), which may be manuallyentered or entered via RFID scan, for example. The instrument notesfield 504 may be used to input any additional notes that may be usefulpertaining to a specific instrument. The instrument view window 498further includes an image window 506, camera icon 508, and a “removeinstrument” button 510. The image-related functionality of theinstrument view window 498 is identical to the image-relatedfunctionality of the tray view screen 462. Thus, the image window 506and camera icon 508 operate in identical fashion to the tray imagewindow 470 and camera icon 488 discussed above. Tapping on an image inthe image window 506 opens a “zoom view” in the same manner as the trayview described above. Pressing the “remove instrument” button 510deletes the instrument from the tray, which causes the computer toremove the instrument ID tag 499 in the interactive instrument list 472.

The standardization software platform 16 of the present disclosure isconfigured to recognize the possibility of stacking trays within theplanogram. Referring to FIG. 64, pressing the “trays” icon 482 causes astacked tray popup window 514 to appear. The stacked tray popup window514 allows a user to create a tray stack by adding trays, and thenmanaging the tray stack by toggling between tray views and adding ordeleting trays as becomes necessary. To add a tray to the stack, a userpresses the “+” icon 516 (for example). In the instant example the userhas created a two-tray stack. To access the information in the firsttray, the user taps on a first tray icon 518, for example a window witha “1” identifier (although other identifiers may be used). This causesthe computer to display the tray view screen 462 for that specificinstrument tray. The user can populate that tray view screen asdescribed above. When the user desires to switch to the tray view screen462 of the other tray in the stack, the user again presses the “trays”button 482, and then a second tray icon 520 in the stacked tray popupwindow 514, for example a window with a “2” identifier. This causes thecomputer to switch to the tray view screen 462 for the second stackedtray. To remove a tray in the stack, the user presses the “−” icon 522that is specific to the stacked tray that the user would like to remove(for example).

Referring to FIG. 65, the “video” button 484 on the tray view screen 462allows the user to add, play, replace and remove videos that are inputinto standardization software platform 16 for that specific instrumenttray. Videos may contain instructions about that specific instrumenttray, including how to assemble or use various instruments within thetray. Pressing the “video” button 484 on the tray view screen 462prompts a popup menu 524 including selectable options to create video526, view library 528, and search videos 530. Choosing the “createvideo” 526 option prompts the computer to open the device's video camerafunction. The user can then record their own video and save it to theapp 16. The “view library” 528 option allows the user to view thelocally stored video library to select an appropriate video. The “searchvideos” 530 option prompts the user to do a cloud search for a relevantvideo. The computer presents a video icon 532 in the menu bar 474 on thetray view screen 462 as well as in the image display 456 of theplanogram when the computer determines that there is at least one videoassociated with the instrument tray. Additionally, videos that are addedin the tray view screen 462 are also added to the video library 564 forthe procedure (FIG. 73). FIG. 64 shows the full-screen video 534 thatpops up when a video is selected. The selected video will also show onany external mirrored displays, for example the monitor 52 on thevertical rack assembly 12 (or operating room wall). Any sound associatedwith the video can be heard through the speakers on portable electronicdevice 17 and/or speakers that may be provided on the vertical rackassembly 12.

When the user is finished setting up the tray view screen 462, the usermay return to the planogram screen 442. The data previously entered isautomatically saved. The interactive location window 454 associated withthat particular instrument tray will now display the same image that isdisplayed in the tray image window 470.

FIG. 67 illustrates an example of a populated but unverified planogramscreen 536, which is what the user will see upon completion of thevarious tray view screens. At this point, each interactive locationwindow 454 displays a representative image of the instrument tray (orother item) in each location. By way of example, the images shown arefull tray images, however other identifiers may be used. In this view,the user may start to place instrument trays within the vertical rackassembly 12 as arranged in the planogram. If during this process (or anyother time) the user decides to rearrange the trays in some way, theinteractive location windows 454 may be moved to a different spot in theplanogram. By way of example, this movement may be accomplished by theuser pressing and holding his/her finger on the location window 454until the window “releases” from the planogram, and then dragging thelocation window 454 to a new location, at which point the user releaseshis/her finger from the display at which time computer may determine arearrangement of location windows to adapt to the new location of thedragged location window.

Referring to FIG. 68, at any time during the setup process or during thesurgery, the user may input information into the surgery preferencenotes window 538, which pops open when the user taps on the surgerypreference notes tab 452. By way of example, these notes may havecertain associated data recorded when the notes are made, for exampleincluding but not limited to time stamp, date, user, and the like. Whenfinished, the user simply taps on the border of the window 538 tocollapse the window 538.

Referring to FIG. 69, the dropdown menu 406 in the information bar 402includes options to select/view username 540, settings 542, and sync544. Selecting the username option 540 displays user information.Selecting the settings option 542 opens a settings menu (not shown) toallow the user to adjust various settings. Selecting the sync option 544allows the user to instruct the computer to sync the data stored in theapp (via WiFi) to the user's cloud profile. This data may include newplanogram settings as well as data collected during a surgery (e.g. userinformation, time stamps, duration, searches performed, tray movements,etc). By way of example, the app 16 may be configured to automaticallysync periodically if the portable device 17 is connected to a WiFinetwork. This menu option gives the user the ability to instruct the app16 to sync immediately.

Referring to FIG. 70, an example of a verified planogram screen 546 isshown. Once the user has placed an instrument tray on the vertical rackassembly 12 in the location ID position corresponding to the planogram,the user may tap the verification toggle 460 to confirm this correctplacement. This may then change the visual indicator associated with theverification toggle 460 to indicate that the tray is verified as“checked in” for example from an “x” visual indicator that symbolizes“not checked in” to a check mark indicator that symbolizes “checked in.”When the verification toggles 460 in all of the interactive locationwindows 454 display a check mark indicator (in the current example),then all the instrument trays have been confirmed as placed in thecorrect position on the vertical rack assembly 12 and the setup processis complete. At this point the surgical tray efficiency system 10 isready for the surgery to begin.

During the surgery, one advantageous feature of the surgical trayefficiency system 10 is the ability for a user to use the app 16 tosearch for a particular instrument, and have the app 16 reveal thelocation of said instrument. To do this, the user taps the “searchinstrument” button 548. Although currently shown as being associatedwith the verified planogram screen 546, it should be understood that the“search instrument” button 548 may be included in other app 16 screensas well. For example, the instrument data is searchable during setup,and not just after setup is complete.

Tapping on the “search instrument” button 548 prompts the computer todirect the user to the search instrument screen 550, an example of whichis shown in FIG. 71. The search instrument screen 550 includes a searchinstrument input field 552 positioned near the top of the screen. Theuser enters the name of the desired instrument into the searchinstrument field 552 and presses the “done” button 554 located on theright of the input field 552. The app 16 will search the instrument namedata and provide a location listing 556 for each instance in which thesearched-for appears. The location listing 556 lists the name andlocation of the instrument. Tapping on the location listing 556 promptsthe computer to direct the user to the instrument view screen 498 forthat particular instrument (e.g. FIG. 63).

FIG. 72 illustrates an example of a mayo stand planogram screen 558 thata user is directed to when they tap on the mayo stand tab 448 describedabove. A mayo stand is basically a utility tray that is used as astaging area for surgical instruments and other material that is in thequeue for impending use during the procedure. The standardizationsoftware system 16 provides for organizing the mayo stand in a similarfashion to the vertical rack assembly 12, with the main difference beingthat unlike the planogram 444 for the vertical rack assembly 12, themayo stand “planogram” 560 does not have a predetermined number oflocation windows that correspond to a particular location. Instead, themayo stand “planogram” 560 may have up to six stage windows 562 that areadded at the user's discretion. The stage windows 562 may be populatedwith any instrument or combination of instruments that the user chooses.Tapping on the any of the stage windows 562 prompts the computer todirect the user to the stage view screen for that particular stage. Thestage view screen is identical to the tray view screen 462 describedpreviously in features and functionality.

FIG. 73 provides an example of a video library screen 564 that may beaccessed by tapping on the video media icon 412 on the default menu bar404 that is present on most GUI screens in the app 16. The video library564 includes a video icon 566 for each video that has been added to thesurgery profile. Videos that pertain to specific instruments will belabeled with the instrument location. Tapping on any video will causethe video to play in a full-screen format (FIG. 66).

FIG. 74 illustrates an example of a procedure library screen 568 thatmay be accessed by tapping on the print media icon 414 on the defaultmenu bar 404 that is present on most GUI screens in the app 16. Theprocedure library 568 is a storage collection for all PDF document filesthat are associated with the surgical procedure. Primarily these arelikely to be various technique guides, however any PDF documentassociated with the procedure may be stored in the procedure library568. The procedure library 568 includes a PDF icon 570 for each PDF filestored therein. Tapping on a PDF file will cause the PDF file to open ina full-screen PDF reader 572 (FIG. 75). The user can turn the page byswiping across the screen or by selecting a page from the page bar 574at the bottom of the screen.

FIG. 76 illustrates an example of a time management screen 576 that maybe accessed by tapping on the “time management” button 416 on thedefault menu bar 404 that is present on most GUI screens in the app 16.The time management screen 576 includes an “Add timer” button 578, thatwhen pressed causes the computer to offer a timer window 580 to theuser. The timer window 580 includes a name field 582 to allow the userto assign a name to the timer, a timer type selector 584 where a userchooses between a count up timer 586 and a countdown timer with alarm588, a time indicator 590 that shows the time remaining on a countdowntimer or the time elapsed on a count-up timer, a start button 592 and astop button 594. The time management screen 576 allows the user toconfigure count up and count down timers that can be used to record andtime certain features such as but not limited to the overall surgerytime, cement set time, set up time and turnover time. Multiple timerscan be used at the same time.

Many variations on the basic design are possible. For example, there maybe more or fewer than four shelves on the vertical rack assembly, theangle at which they are mounted to the rack may be greater or less thanthirty degrees, the shelf angle may be adjustable. The length of eachshelf may be sufficient length for one or more surgical tray lengths.The shelves may include a sensor array (e.g. pressure, mechanical,electrical) to collect certain data. The sterile identification barrieralso may vary in length and number of identification labels to correlateto the length of the vertical rack assembly. The standardizationsoftware platform also may vary depending on the number andconfiguration of vertical shelf assemblies used for a given surgicalprocedure.

In some instances, it may be advantages to mount the surgical trayefficiency to the operating room wall or ceiling. FIG. 77 illustrates anexample of a ceiling attachment feature 600 that can be used with avertical rack assembly 12 to secure the vertical rack assembly 12 to theceiling. By way of example, the ceiling attachment feature comprises aboom assembly 602, however any suitable mechanism of attachment to awall or ceiling may be used. The boom assembly 602 includes (by way ofexample only) a first extension 604 pivotally associated with a secondextension 606. A ceiling mount 608 for mounting the boom assembly 602 tothe ceiling is rotatably attached to one end of the first extension 604.The second extension 606 is pivotally connected to the first extension604 at the end of the first extension 604 that is opposite the ceilingmount 608. The second extension 606 is rotatably connected to aconnector element 610 at the end of the second extension 606 that isopposite the first extension 604. The connector element 610 securelyconnects the vertical rack assembly 12 and the ceiling attachmentfeature 60. By way of example, the connector element 610 of the presentexample comprises a post that attaches to the pivot bar 50 (FIG. 7),however any mechanism capable of securely attaching the vertical rackassembly 12 to the ceiling attachment feature 600 may be used withoutdeparting from the scope of this disclosure.

In some instances, it may be useful to have vertical rack assembly 12with a different shelf configuration from the examples previously shownand described. FIG. 78 illustrates another example of a vertical shelfassembly 620 according to the disclosure. The vertical shelf assembly620 includes a plurality of shelves configured to receive instrumenttrays. By way of example, the vertical shelf assembly 620 includes afirst shelf 622, a second shelf 624, and a third shelf 626. The firstshelf 622 is deep enough (e.g. front-to-back) to receive surgicalinstrument trays that are arranged perpendicular to a longitudinal axisrunning through the first shelf 622. By way of example, the second andthird shelves 624, 626 are identical to the corresponding shelvesdescribed above.

Another notable feature highlighted by the present example is theextended height differential between the first shelf 622 and the secondshelf 624. This may be useful to ensure proper access to all theinstruments within a tray, particularly in the event that the trayssituated in the first shelf 622 are rotated ninety degrees relative tothe trays in the second shelf 624.

The vertical shelf assembly 620 shown by way of example further includesa plurality of risers 628 attached to the base frame. The risers 628include telescoping feet 630 that endeavor to raise the height of thevertical rack assembly 620. Other ways of adjusting the height of thevertical rack assembly 620 may be possible, including but not limited totelescoping vertical supports 632 and/or a central telescoping post thatmay be expanded mechanically, electronically, pneumatically,hydraulically, etc. Additionally, the various shelves may be expandable(e.g. from “double-wide” to “triple-wide” and vice versa) withoutdeparting from the scope of the disclosure. Although the various shelvesare shown and described herein by way of example as being fixed to thevertical rack assembly 12 at a particular angle, optionally one or moreof the shelves may be angularly adjustable relative to the vertebralrack assembly and one another. In addition, the shelves may beheight-adjustable relative to one another. By way of example only, theadjustment mechanisms may be manual, mechanical, electronic, magnetic,pneumatic, or hydraulic in nature. Taking into account theheight-adjustability of the vertebral rack assembly, the vertical rackassembly may be fully adjustable to support a user's needs,

FIG. 79 illustrates an example of an identification/tracking assembly640 that may be used to create/capture data regarding certain surgicalinstruments (or other items) that may be imported into and displayed onthe instrument view screen of the app 16 discussed above, and lateranalyzed for instrument tracking purposes. By way of example only, theidentification assembly 640 comprises a camera/scanner 642, anidentification interface 644, a scale 646, a label printer 648 andattachment element 650 that provides the support necessary to mount theidentification assembly 640 onto a vertical rack assembly (notpictured). The camera/scanner 642 may be provided to take images ofinstruments to populate the planogram as described above, as well as forinstrument tracking purposes. In one example the computer may includeinstrument recognition software that works with the camera/scanner 642to automatically recognize assign identification data to variousinstruments as the image is captured. The camera/scanner 642 may beconfigured to scan RFID, bar codes, etc to capture/load instrument data(for example stock photos, videos, technique guides, and the like) andtracking information. Instrument tracking may also be integrated withthe cloud via WiFi. The scale 646 may be calibrated to determine weightat least to the nearest milligram.

FIG. 80 illustrates another example of a vertical rack assembly 660,illustrating in particular the feature of attached light elements 662.The attached light elements 662 provide additional lighting for thesurgical instrument trays. The attached light elements 662 may beconnected to a power source housed in the base of the vertical rackassembly 660 or alternatively be connected to an external power source,for example such as a wall socket. The attached light elements 662 maybe positioned above the vertical rack assembly, on the shelves (e.g.luminescent track lighting), and/or within the shelves (e.g. for sterilenon-metallic shelves). The attached light elements 662 may be configuredto right up particular areas at particular times, for example when auser executes a search for a particular instrument in the planogramsoftware, the computer not only display's the location ID of theinstrument on the user's GUI but may also cause light elements 662 inthe area of the identified location to illuminate.

In a similar configuration to the light elements 662, the vertical rackassembly 12 may be equipped with localized sterilization element such asaerosol, vacuum, and/or anti-microbial sprays. The sterilizationelements may be controlled manually and/or automatically to sterilizeaccording to a preset timer. The sterilization elements may beconfigured to cover all instruments at the same time, or alternatively(or in addition) be configured to act over a certain specified area(e.g. single tray, shelf zone, quadrant, etc).

FIG. 81 illustrates another example of a vertical rack assembly 670,illustrating in particular the feature of an attached basin or mayostand 672. The attached basin or mayo stand 672 may be a useful stagingarea for instruments that are or will be imminently needed during aprocedure. As the user is retrieving instruments for the mayostand/basin, the user may populate the mayo stand planogram in the App16 as described above. By way of example, the attached basin or mayostand 672 may be attached to the side of the vertical rack assembly andbe moveable to a more desirable position. Alternatively, the mayostand/basin may be slideably attached to the vertical rack assembly forexample above or below the grab handle 48.

Many variations to the standardization software platform 16 are alsopossible. For example, although the user input interface has beendescribed herein as touch (or mouse) based, in some instances thestandardization software platform 16 may include a voice recognitioncomponent, enabling the computer to respond to vocal input commands. Forexample, a user may initiate an instrument search by speaking aloud thename of the instrument (e.g. “Find reamer”). The computer receives thevocal input, analyzes the command and then displays the virtual locationof the requested instrument on the planogram display (and optionally maycause the actual illumination of the instrument tray located on thevertical rack assembly 12). The software may continuously update in realtime a digital planogram preference list, with smart tool integrationsuch that the software “learns” (e.g. based on use patterns, etc.) themost-used tools/kits for a given procedure and the sequence of use ofsuch tools to create a “most played list” where the more commonly-usedtools are at the top of the list and thus more easily found. Thesoftware may be configured to provide the surgical team a pre-opwalkthrough so everyone knows what to expect when it is time for thesurgery.

The software may be configured to have more real time functionality, forexample maintaining an up-to-date operating time line, with digitalnotification of certain events including but not limited to start time,procedure type, length, room location, complexity, staffing, timerexpiration (integrated with time management function), and the like.Also, the software may enable/record secure, real time communicationwith offsite instrument vendor representatives, thereby reducing theneed (e.g. expense, scheduling, crowding, etc.) for vendorrepresentatives to be physically present in the operating room during aprocedure. This communication may include video conferencing. Thesurgeon could be wearing a head-mounted camera (for example located oneyewear or a headband) to enable the offsite representative to “see”what the surgeon is seeing in real time. The software may be configuredto record the video images captured through the head-mounted camera.

In some implementations, the planogram computer processes may be able tocommunicate with robotic devices that are directly or indirectly used insurgical procedures or other surgical-related tasks. For example,various different types of robotic devices may be used in surgicalprocedures, such as robotic devices performing surgical proceduresautonomously, robotic devices operating under the direction of asurgeon, and robotic devices that are used to simply retrieve surgicalinstruments for the surgeon or another member of the surgical team.

The planogram computer processes may receive a request to provide arobotic device with a location of a particular surgical instrument. Therequest may have been issued by a different computer process that workscommunicatively with the robotic device to retrieve surgical instrumentsfor the robotic device. In some examples, the request is issuedautonomously by a robotic device that is working autonomously to performa surgical procedure or a portion thereof (e.g., a robotic device thatis autonomously stitching a wound may autonomously request the locationon vertical rack assembly 12 of a different-sized needle). In someexamples, the request is issued by the robotic device or correspondingcomputer process in response to user input that was provided by a userof the robotic device, such as a surgeon. Indeed, an on-site or remotesurgeon operating the robotic device may provide input specifying theneed for a different surgical instrument to cause the robotic device toretrieve the surgical instrument, rather than manually manipulating anarm or other portion of the robotic device to a location of a surgicalinstrument on vertical rack assembly 12.

The robotic computer process may transmit the request to the planogramsoftware process through an Application Program Interface (API) of theplanogram software process, and may specify the particular surgicalinstrument requested (e.g., by name or unique identifier). In response,the planogram computer process, may determine whether the instrument isstored by any tray in the vertical rack assembly. If so, then theplanogram computer process may return to the robotic computer process anindication of a location of the requested instrument on the verticalrack assembly, or instructions for accessing the requested instrument.

In response to the robotic software process receiving the indication ofthe location of the requested instrument (or movements to perform toaccess the instrument), the robotic device or a component thereof maymove to a tray at which the requested tool is located, and may performoperations to determine a location of the requested instrument on thetray.

Those additional actions can include analyzing one or more images thatare captured by a camera attached to the robotic device, the verticalrack assembly 12, or one that is mounted elsewhere in the surgical room.A computing system can compare such images to pre-stored images of thesurgical instrument, to identify which item located on a tram is thesurgical instrument. Alternatively or additionally, the robotic devicecan include other types of sensors for use in determining or verifyingthe identity of a surgical instrument. For example, the surgicalinstrument may include unique identifiers that can be read by infraredsensors or RFID systems.

At this point, the robotic device may grab the requested instrument orotherwise perform actions for attaching the requested instrument to therobotic device. The robotic device may then give the robotic instrumentto another robot, the surgeon or another member of the surgical team.Should the robotic device keep the instrument rather handing it off to adevice or person, at this point the robotic device may use theinstrument in the surgical procedure. Planogram computer processes mayindicate that the instrument is in use.

Returning a surgical instrument generally involves performing similaroperations, but in reverse. For example, an autonomous robotic device oran operator of a robotic device may determine that a differentinstrument is needed. At this point, the robotic device may eitherreturn its currently-attached or held robotic instrument to the locationon a tray at which it was previously taken, or the computer processesoperating in conjunction with the robotic device may send a request tothe planogram computer processes to determine a location at which toplace the robotic instrument, and the planogram computer process maysend back information that identifies such a location. The roboticinstrument may perform such a query to ensure that the roboticinstrument is placed in its correct location, even if trays orinstruments thereon have been moved since the time that the roboticinstrument retrieved the instrument.

The robotic device may then return the instrument to its preferredlocation on a vertical rack assembly 12, and the planogram userinterface may provide a graphical indication that the instrument is nowstored on the vertical rack assembly 12.

FIG. 82 is a block diagram of computing devices 7500, 7550 that may beused to implement the systems and methods described in this document, aseither a client or as a server or plurality of servers. Computing device7500 is intended to represent various forms of digital computers, suchas laptops, desktops, workstations, personal digital assistants,servers, blade servers, mainframes, and other appropriate computers.Computing device 7550 is intended to represent various forms of mobiledevices, such as personal digital assistants, cellular telephones,smartphones, and other similar computing devices. In this example,computing device 7550 may represent electronic device 17, whilecomputing device 7500 may represent computing systems that serve as the“cloud” referenced in this disclosure. The components shown here, theirconnections and relationships, and their functions, are meant to beexamples only, and are not meant to limit implementations describedand/or claimed in this document.

Computing device 7500 includes a processor 7502, memory 7504, a storagedevice 7506, a high-speed interface 7508 connecting to memory 7504 andhigh-speed expansion ports 7510, and a low speed interface 7512connecting to low speed bus 7514 and storage device 7506. Each of thecomponents 7502, 7504, 7506, 7508, 7510, and 7512, are interconnectedusing various busses, and may be mounted on a common motherboard or inother manners as appropriate. The processor 7502 can processinstructions for execution within the computing device 7500, includinginstructions stored in the memory 7504 or on the storage device 7506 todisplay graphical information for a GUI on an external input/outputdevice, such as display 7516 coupled to high-speed interface 7508. Inother implementations, multiple processors and/or multiple buses may beused, as appropriate, along with multiple memories and types of memory.Also, multiple computing devices 7500 may be connected, with each deviceproviding portions of the necessary operations (e.g., as a server bank,a group of blade servers, or a multi-processor system).

The memory 7504 stores information within the computing device 7500. Inone implementation, the memory 7504 is a volatile memory unit or units.In another implementation, the memory 7504 is a non-volatile memory unitor units. The memory 7504 may also be another form of computer-readablemedium, such as a magnetic or optical disk.

The storage device 7506 is capable of providing mass storage for thecomputing device 7500. In one implementation, the storage device 7506may be or contain a computer-readable medium, such as a floppy diskdevice, a hard disk device, an optical disk device, or a tape device, aflash memory or other similar solid state memory device, or an array ofdevices, including devices in a storage area network or otherconfigurations. A computer program product can be tangibly embodied inan information carrier. The computer program product may also containinstructions that, when executed, perform one or more methods, such asthose described above. The information carrier is a computer- ormachine-readable medium, such as the memory 7504, the storage device7506, or memory on processor 7502.

The high-speed controller 7508 manages bandwidth-intensive operationsfor the computing device 7500, while the low speed controller 7512manages lower bandwidth-intensive operations. Such allocation offunctions is by way of example only. In one implementation, thehigh-speed controller 7508 is coupled to memory 7504, display 7516(e.g., through a graphics processor or accelerator), and to high-speedexpansion ports 7510, which may accept various expansion cards (notshown). In the implementation, low-speed controller 7512 is coupled tostorage device 7506 and low-speed expansion port 7514. The low-speedexpansion port, which may include various communication ports (e.g.,USB, Bluetooth, Ethernet, wireless Ethernet) may be coupled to one ormore input/output devices, such as a keyboard, a pointing device, ascanner, or a networking device such as a switch or router, e.g.,through a network adapter.

The computing device 7500 may be implemented in a number of differentforms, as shown in the figure. For example, it may be implemented as astandard server 7520, or multiple times in a group of such servers. Itmay also be implemented as part of a rack server system 7524. Inaddition, it may be implemented in a personal computer such as a laptopcomputer 7522. Alternatively, components from computing device 7500 maybe combined with other components in a mobile device (not shown), suchas device 7550. Each of such devices may contain one or more ofcomputing device 7500, 7550, and an entire system may be made up ofmultiple computing devices 7500, 7550 communicating with each other.

Computing device 7550 includes a processor 7552, memory 7564, aninput/output device such as a display 7554, a communication interface7566, and a transceiver 7568, among other components. The device 7550may also be provided with a storage device, such as a microdrive orother device, to provide additional storage. Each of the components7550, 7552, 7564, 7554, 7566, and 7568, are interconnected using variousbuses, and several of the components may be mounted on a commonmotherboard or in other manners as appropriate.

The processor 7552 can execute instructions within the computing device7550, including instructions stored in the memory 7564. The processormay be implemented as a chipset of chips that include separate andmultiple analog and digital processors. Additionally, the processor maybe implemented using any of a number of architectures. For example, theprocessor 410 may be a CISC (Complex Instruction Set Computers)processor, a RISC (Reduced Instruction Set Computer) processor, or aMISC (Minimal Instruction Set Computer) processor. The processor mayprovide, for example, for coordination of the other components of thedevice 7550, such as control of user interfaces, applications run bydevice 7550, and wireless communication by device 7550.

Processor 7552 may communicate with a user through control interface7558 and display interface 7556 coupled to a display 7554. The display7554 may be, for example, a TFT (Thin-Film-Transistor Liquid CrystalDisplay) display or an OLED (Organic Light Emitting Diode) display, orother appropriate display technology. The display interface 7556 maycomprise appropriate circuitry for driving the display 7554 to presentgraphical and other information to a user. The control interface 7558may receive commands from a user and convert them for submission to theprocessor 7552. In addition, an external interface 7562 may be providedin communication with processor 7552, so as to enable near areacommunication of device 7550 with other devices. External interface 7562may provide, for example, for wired communication in someimplementations, or for wireless communication in other implementations,and multiple interfaces may also be used.

The memory 7564 stores information within the computing device 7550. Thememory 7564 can be implemented as one or more of a computer-readablemedium or media, a volatile memory unit or units, or a non-volatilememory unit or units. Expansion memory 7574 may also be provided andconnected to device 7550 through expansion interface 7572, which mayinclude, for example, a SIMM (Single In Line Memory Module) cardinterface. Such expansion memory 7574 may provide extra storage spacefor device 7550, or may also store applications or other information fordevice 7550. Specifically, expansion memory 7574 may includeinstructions to carry out or supplement the processes described above,and may include secure information also. Thus, for example, expansionmemory 7574 may be provided as a security module for device 7550, andmay be programmed with instructions that permit secure use of device7550. In addition, secure applications may be provided via the SIMMcards, along with additional information, such as placing identifyinginformation on the SIMM card in a non-hackable manner.

The memory may include, for example, flash memory and/or NVRAM memory,as discussed below. In one implementation, a computer program product istangibly embodied in an information carrier. The computer programproduct contains instructions that, when executed, cause performance ofone or more methods, such as those described above. The informationcarrier is a computer- or machine-readable medium, such as the memory7564, expansion memory 7574, or memory on processor 7552 that may bereceived, for example, over transceiver 7568 or external interface 7562.

Device 7550 may communicate wirelessly through communication interface7566, which may include digital signal processing circuitry wherenecessary. Communication interface 7566 may provide for communicationsunder various modes or protocols, such as GSM voice calls, SMS, EMS, orMMS messaging, CDMA, TDMA, PDC, WCDMA, CDMA2000, or GPRS, among others.Such communication may occur, for example, through radio-frequencytransceiver 7568. In addition, short-range communication may occur, suchas using a Bluetooth, WiFi, or other such transceiver (not shown). Inaddition, GPS (Global Positioning System) receiver module 7570 mayprovide additional navigation- and location-related wireless data todevice 7550, which may be used as appropriate by applications running ondevice 7550.

Device 7550 may also communicate audibly using audio codec 7560, whichmay receive spoken information from a user and convert it to usabledigital information. Audio codec 7560 may likewise generate audiblesound for a user, such as through a speaker, e.g., in a handset ofdevice 7550. Such sound may include sound from voice telephone calls,may include recorded sound (e.g., voice messages, music files, etc.) andmay also include sound generated by applications operating on device7550.

The computing device 7550 may be implemented in a number of differentforms, some of which are shown in the figure. For example, it may beimplemented as a cellular telephone 7580. It may also be implemented aspart of a smartphone 7582, personal digital assistant, or other similarmobile device.

Additionally computing device 7500 or 7550 can include Universal SerialBus (USB) flash drives. The USB flash drives may store operating systemsand other applications. The USB flash drives can include input/outputcomponents, such as a wireless transmitter or USB connector that may beinserted into a USB port of another computing device.

Various implementations of the systems and techniques described here canbe realized in digital electronic circuitry, integrated circuitry,specially designed ASICs (application specific integrated circuits),computer hardware, firmware, software, and/or combinations thereof.These various implementations can include implementation in one or morecomputer programs that are executable and/or interpretable on aprogrammable system including at least one programmable processor, whichmay be special or general purpose, coupled to receive data andinstructions from, and to transmit data and instructions to, a storagesystem, at least one input device, and at least one output device.

These computer programs (also known as programs, software, softwareapplications or code) include machine instructions for a programmableprocessor, and can be implemented in a high-level procedural and/orobject-oriented programming language, and/or in assembly/machinelanguage. As used herein, the terms “machine-readable medium” and“computer-readable medium” refer to any computer program product,apparatus and/or device (e.g., magnetic discs, optical disks, memory,Programmable Logic Devices (PLDs)) used to provide machine instructionsand/or data to a programmable processor.

To provide for interaction with a user, the systems and techniquesdescribed here can be implemented on a computer having a display device(e.g., a CRT (cathode ray tube) or LCD (liquid crystal display) monitor)for displaying information to the user and a keyboard and a pointingdevice (e.g., a mouse or a trackball) by which the user can provideinput to the computer. Other kinds of devices can be used to provide forinteraction with a user as well; for example, feedback provided to theuser can be any form of sensory feedback (e.g., visual feedback,auditory feedback, or tactile feedback); and input from the user can bereceived in any form, including acoustic, speech, or tactile input.

The systems and techniques described here can be implemented in acomputing system that includes a back end component (e.g., as a dataserver), or that includes a middleware component (e.g., an applicationserver), or that includes a front end component (e.g., a client computerhaving a graphical user interface or a Web browser through which a usercan interact with an implementation of the systems and techniquesdescribed here), or any combination of such back end, middleware, orfront end components. The components of the system can be interconnectedby any form or medium of digital data communication (e.g., acommunication network). Examples of communication networks include alocal area network (“LAN”), a wide area network (“WAN”), peer-to-peernetworks (having ad-hoc or static members), grid computinginfrastructures, and the Internet.

The computing system can include clients and servers. A client andserver are generally remote from each other and typically interactthrough a communication network. The relationship of client and serverarises by virtue of computer programs running on the respectivecomputers and having a client-server relationship to each other.

While the inventive features described herein have been described interms of a preferred embodiment for achieving the objectives, it will beappreciated by those skilled in the art that variations may beaccomplished in view of these teachings without deviating from thespirit or scope of the invention. Furthermore, the various features ofthe invention have been described using several example embodiments. Itshould be understood that any feature or combination of featuresdescribed with regard to a particular example embodiment may be appliedto any other example embodiment in any combination without reservation.

We claim:
 1. A system for increasing efficiency in an operating roomenvironment during a surgical procedure, comprising: a multi-level shelfassembly comprising a plurality of elongated shelves verticallyseparated from one another, each elongated shelf having a generallyplanar display surface configured to hold at least one standard surgicalinstrument tray, wherein the plurality of elongated shelves includes afirst shelf having a generally planar display surface oriented parallelto the ground, and a second shelf having a generally planar displaysurface arranged in a nonparallel orientation relative to the firstshelf; a sterile identification barrier overlaying the multi-level shelfassembly to create a physical barrier between a sterile field of anoperating room and the multi-level shelf assembly, the sterileidentification barrier including a plurality of tray-receiving areas,each sized and configured to overlay at least a portion of one of theelongated shelves and containing only one standard surgical instrumenttray therein, each tray-receiving area having a unique tray-receivingarea location identifier associated therewith; and computer-readablemedia including instructions that, when executed by one or moreprocessors, are configured to cause a computer system to: receivesurgical planning data that is related to a given surgical procedure andthat is input by a user, the surgical planning data comprising: (i)surgical instrument tray content that indicates surgical instruments tobe stored on various surgical instrument trays, and (ii) tray-receivingarea location identifiers that correspond directly to the tray-receivingarea location identifiers of the sterile identification barrier, andthat indicate the locations of the various surgical instrument trays onthe sterile identification barrier during the given surgical procedure,and provide, on a display device, an interactive presentation thatindicates: (i) the surgical instruments that are to be stored on thevarious surgical instrument trays, and (ii) the locations of the varioussurgical instrument trays on the sterile identification barrier duringthe given surgical procedure.
 2. The system of claim 1, wherein theplurality of elongated shelves further includes a third shelf having agenerally planar display surface arranged in a nonparallel orientationrelative to the first shelf.
 3. The system of claim 2, wherein thegenerally planar display surface of the third shelf is arranged in anonparallel orientation relative to the second shelf.
 4. The system ofclaim 2, wherein the plurality of elongated shelves further includes afourth shelf having a generally planar display surface arranged in anonparallel orientation relative to the first shelf.
 5. The system ofclaim 4, wherein the generally planar display surface of the fourthshelf is arranged in a nonparallel orientation relative to the secondand third shelves.
 6. The system of claim 4, wherein the first, second,third and fourth shelves are equal in length.
 7. The system of claim 6,wherein the first shelf has a width dimension that is greater than thewidth dimensions of the second, third, and fourth shelves.
 8. The systemof claim 1, wherein the display device is attached to the multi-levelshelf assembly.
 9. The system of claim 1, wherein unique locationidentifiers on the sterile identification barrier comprise at least oneof letters, numbers, colors, symbols, and words.
 10. The system of claim1, wherein the sterile identification barrier further includes aplurality of bendable wires positioned thereon to secure the sterileidentification barrier to the multi-level shelf assembly.
 11. The systemof claim 1, wherein the sterile identification barrier is at leastpartially secured to the multi-level shelf assembly by hook and loopfasteners.
 12. The system of claim 1, wherein the surgical instrumenttray content comprises a plurality of surgical instruments.
 13. Thesystem of claim 12, wherein the surgical planning data input by the userfurther comprises at least one of hospital name, surgeon name, procedurename, procedure-related literature, procedure-related video media,instrument-specific video media, instrument images, and surgerypreference notes.
 14. The system of claim 13, wherein the instructionsare further configured to cause the computer system to: provide one ormore user interface elements that enable a user to search for a surgicalinstrument by name, and present, in response to user input that providesa name of a surgical instrument and initiates a search using the one ormore user interface elements, information that indicates a surgicalinstrument tray on which a surgical instrument having the name islocated.
 15. The system of claim 14, wherein the interactivepresentation includes a virtual representation of the location on thesterile identification barrier of the surgical instrument that has thename.
 16. The system of claim 1, wherein the multi-level shelf assemblyis mounted to the ceiling of the operating room.
 17. The system of claim1, wherein the instructions are further configured to cause the computersystem to: receive a request to provide a second computer system thatcoordinates movements of a robotic device with a location of aparticular surgical instrument, wherein the request indicates theparticular surgical instrument; identify a surgical instrument tray, ofthe various surgical instrument trays, at which the particular surgicalinstrument is located; and send, for receipt by the computer system thatcoordinates movements of the robotic device in response to havingreceived the request, information that indicates the surgical instrumenttray at which the particular surgical instrument is located.
 18. Thesystem of claim 17, wherein the instructions are further configured tocause the computer system to: receive, from the computer system thatcoordinates movements of the robotic device, information that indicatesthat the robotic device has retrieved the particular surgicalinstrument; and provide, on the display device, an update to theinteractive presentation to visually indicate that the particularsurgical instrument has been retrieved by the robotic device.
 19. Amethod for increasing efficiency in an operating room environment duringa given surgical procedure, comprising the steps of: providing aplurality of surgical instrument trays, each containing one or moresurgical instruments related to the given surgical procedure; providinga multi-level shelf assembly comprising a plurality of elongated shelvesvertically separated from one another, each elongated shelf having agenerally planar display surface configured to hold at least onesurgical instrument tray; draping a sterile identification barrier overthe multi-level shelf assembly to create a physical barrier between thesterile field of the operating room environment and the multi-levelshelf assembly, the sterile identification barrier including a pluralityof tray-receiving areas, each sized and configured to overlay at least aportion of one of the elongated shelves and contain only one surgicalinstrument tray therein, each tray-receiving area having a uniquelocation identifier associated therewith; inputting surgical planningdata related to a given surgical procedure into a computer system, thesurgical planning data comprising: (i) surgical instrument tray contentthat indicates surgical instruments to be stored on various surgicalinstrument trays, and (ii) tray-receiving area location identifiers thatcorrespond directly to the tray-receiving area location identifiers ofthe sterile identification barrier, and that indicate the locations ofthe various surgical instrument trays on the sterile identificationbarrier during the given surgical procedure; affixing a unique locationidentifier tag to the surgical instrument trays, the unique locationidentifier tag corresponding to the locations of the various surgicalinstrument trays on the sterile identification barrier during the givensurgical procedure; placing the specific surgical instrument tray withaffixed location identifier tag within the tray-receiving area havingthe corresponding tray-receiving area location identifier; andinteracting, with a computer system that is providing, on a displaydevice, an interactive presentation that indicates (i) the surgicalinstruments that are to be stored on the various surgical instrumenttrays, and (ii) the locations of the various surgical instrument trayson the sterile identification barrier during the given surgicalprocedure, to select a particular surgical instrument tray and cause thedisplay device to present an enlarged view of the particular surgicalinstrument tray.